Inflammatory Joint Disease

Treatment of DMARD naïve patients with poor prognosis rheumatoid arthritis using Rituximab: A pilot study evaluating synovial outcomes
Principal Investigator: Hani El-Gabalawy
Co-Principal Investigators: F. Aoudjit, C. Hitchon, B. Elias

Abstract: Early treatment of RA is the best strategy for preventing joint damage and functional loss. Rituximab, a biologic treatment that reduces disease causing B lymphocytes, is currently approved for use in RA after other treatments have failed. We hypothesize that early use of this drug can change the course of severe RA by depleting B cells in the inflamed synovium and making the disease milder. We propose an open label study of 15 severe early RA patients who will receive a course of rituximab. We will study the effects on synovium, blood lymphocytes, disease activity, and patient perceptions.

Development and usability and feasibility testing of a web-based self-management intervention for adolescents with arthritis
Principal Investigator: Patrick McGrath
Co-Principal Investigators: J. Stinson, E. Hodnett, B. Feldman, C. Duffy, A. Huber, L. Tucker, R. Hetherington, R. Yeung

Abstract: Juvenile Idiopathic Arthritis (JIA) is a chronic childhood illness that negatively impacts quality of life. While activities to manage JIA are shared by the child and family, adolescents are expected to assume a greater role in disease management. Greater self-management early on could help prevent worsening of the disease and symptoms. Therefore, it is important to develop interventions to assist adolescents to manage their disease. This study will develop and evaluate the usability and feasibility of the “Teens Taking Charge: Managing Arthritis On-line” web-based intervention of self-management, information, and social support to improve quality of life of adolescents with arthritis.

Diagnostic tools for inflammatory arthritis
Principal Investigator: Katherine Siminovitch
Co-Principal Investigators: C. McCulloch, S. Bernatsky, C. Bombardier, E. Keystone, J. Sodek, R. Yeung

Abstract: This proposal is aimed at development of tools enabling improved diagnosis and course/outcome prediction in adult rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA). We have shown that certain classes of proteins in blood and synovial T cells and fibroblasts are abnormally active in RA/JIA. Our data suggest that these changes may serve as diagnostic markers and/or predictors of disease course and severity. We will now further characterize the “activated” protein patterns, develop tools to detect such patterns, and evaluate pattern correlations with disease course/outcome. These newly-developed tools will enable the most timely and beneficial use of medications in RA/JIA.