Rheumatoid Arthritis

RHEUMATOID ARTHRITIS INFORMATION PAGE

As a service to those diagnosed with rheumatoid arthritis and their families we have assembled a number of sites which we feel aid in the understanding of the disease. These sites provide useful information on how to better control and manage your life until better treatments, or cure(s) are found.

Please bookmark our site now! After you visit these other sites, we welcome you back to learn of a new rheumatoid arthritis test kit. We feel this kit will better aid doctors in determining the best disease modifying therapy for individual patients. Rheumatologists will now be able to apply preventive steps, perhaps more aggressively, for those who test at a higher risk for developing severe rheumatoid arthritis or, conversely, reduce the level of therapy for those rheumatoid arthritis patients who test at the low end of the scale. Until now, such testing has not been routinely available for rheumatoid arthritis patients.

Arthritis pages of drdoc on-line
Rheumatoid Arthritis Duquesne University
SkyDancer's Arthritis Information Page
The Arthritis Foundation: Atlanta, Georgia
Amazon.com: Check out their comprehensive list of book resources.
Doctor's Guide to the Internet^TM
The Canadian Arthritis Foundation

If you would like your site added
to this list please e-mail us.

As you have learned, rheumatoid arthritis is a chronic, systemic, autoimmune disease that primarily affects the synovial membranes of multiple joints in the body. The symptoms and types of joints affected and the nature of other organs involved, such as the eyes, lungs, or skin vary among individuals. Rheumatoid arthritis is cyclical in nature; having periods when the patient feels better or even cured, and periods when the patient feels worse. Partly because of this, patients may not follow their treatment plans closely and later suffer permanent joint damage and limited movement, which might have been avoided.

Cause

The disease is initiated by an unknown antigen, possibly bacterial or viral, and develops in patients with a genetic predisposition to the disease. It has been independently established that particular subtypes of the HLA-DR4 gene give a strong prediction for the development of severe rheumatoid arthritis [1-11]. TNB Laboratories (TNB) has come up with a set of monoclonal antibodies for detecting HLA-DR4, the RA susceptibility sequence QKRAA/QRRAA and the two subtypes of HLA-DR4 that have been shown to indicate the most severe prognosis for a new RA patient (DRB1*0401 & DRB1*0404). These antibodies are now available in kit form. Terra Nova Biotechnology expects that this prognostic information will soon become the key to enhanced therapy planning for new patients with suspected rheumatoid arthritis.

Making the Correct Diagnosis

Rheumatoid arthritis shares many clinical findings with other autoimmune diseases. Making a differential diagnosis is often difficult particularly at the early stages of development because it may begin gradually with subtle symptoms. Sometimes, diagnosing rheumatoid arthritis takes several visits to the doctor and several tests, which may include blood tests, urine tests, x-rays and tests of fluid from the joint tissue. None of the tests are perfect, and no single test will verify the presence of rheumatoid arthritis.

Drug Therapy

Based upon the results of a comprehensive examination, including laboratory data, the patient's physician will carefully choose the class of drugs that will most likely optimize the therapeutic benefit to the patient. It is important to note that most of the drugs generally prescribed have significant side effects, and can be (in rare instances) fatal.

Physicians treat arthritis patients with high doses of aspirin, nonsteroidal anti-inflammatory drugs, gold compounds, and corticosteroids. Drug selection and treatment has now become easier for Rheumatologists. Early in 1997, the NovaPRO RA test became available throughout Canada. Combined with a doctor's clinical evaluation, the NovaPRO test can help physicians determine the best disease modifying therapy. Clinical data confirming the effectiveness of this test has been recorded. Independent studies conducted by Dr. Edward Keystone and Dr. Dafna Gladman from The Wellesly Hospital, Toronto, Canada and Dr. Ian Wicks from The Royal Melbourne Hospital, Melbourne, Australia show that the NovaPRO test offers impressive accuracy in predicting the disease course of rheumatoid arthritis patients.

TNB Laboratories's Vision

TNB's intent is to enhance the level of patient care while maintaining economic responsibility in the delivery of these improvements. Based upon feedback received to date, we believe our NovaPRO kit can meet the important criteria of cost-effective healthcare improvements through targeted utilization of expensive therapeutic drugs (where the beneficiaries are the patients and their increased quality of life). This position is especially important here in North America where government funding is slashed and rationalization is the norm.

Financial burdens placed on the patient and family due to disease progression, all add to the stress endured by rheumatoid arthritis patients. Health care professionals should work with patients and their families to establish reasonable goals, and foster a positive outlook emphasizing the ability to minimize the consequences of rheumatoid arthritis over the long term. They should also provide their patients with as much information as possible so that appropriate plans can be made ahead of time depending on the predicted course, whether mild or severe, of the disease.

TNB's Credentials

TNB's research laboratory is based in immunology, particularly with cellular immunology and monoclonal antibody technology, and has a team of scientists with greater than 60 years combined experience in this field. The company has been certified to ISO 9002 for the manufacture of monoclonal antibodies and in vitro diagnostic kits. TNB has received Health Canada, Health Protection Branch product notification for its NovaPRO test kit, permitting clinical use in Canada.

Summary

The NovaPRO test kit has been developed as a quick, inexpensive and simple alternative to other molecular methods for determining the genetic predisposition of rheumatoid arthritis patients for the disease. It is our belief that genetic confirmation will enable rheumatologists to confidently develop the best therapeutic strategy for each patient. By using the NovaPRO kit, physicians will now be able to aggressively treat patients prior to destructive changes in bones or joints and will be able to reduce the possible overtreatment, using potentially toxic drugs, of mild rheumatoid arthritis patients. Also, after considering this information, patients will be better informed when making plans for their future and perhaps adhere to their treatment regimens more diligently.

References
1. Nepom, G.T. and Erlich, H.A. (1991) Ann. Rev. Immunol. 9, 493.
2. Wordsworth, B.P. and Bell, J.I. (1992) Springer Seminar Immunopathol. 14, 59.
3. Gregersen, P.K., Silver, J. and Winchester, R.J. (1987) Arthritis Rheum. 30, 1205.
4. Winchester, R.J. (1992) Ann. Int. Med. 117, 869.
5. Weyand, C.M., Hicok, K.C., Conn, D.L. and Goronzy, J.J. (1992) Ann. Int. Med. 117, 801.
6. Weyand, C.M., McCarthy, T.G. and Goronzy, J.J. (1995) J. Clin. Invest. 95, 2120.
7. Wordsworth, P., Pile, K.D., Buckley, J.D., Lanchbury, J.S.S., Ollier, B., Lathrop, M. and Bell, J.I. (1992) Am. J. Hum. Genet. 51, 585.
8. MacGregor, A., Ollier, W., Thompson, W., Jawaheer, D. and Silman, A. (1995) J. Rheumatol. 22, 1032.
9. vanZeben, D., Hazes, J.M.W., Zwinder-man, A.H., Vanderbroucke, J.P. and Breedfeld, F.C. (1993) J. Rheumatol. 20, 1288.
10. Gough, A., Faint, J., Salmon, M., Hassell, A., Wordsworth, P., Pilling, D., Birley, A. and Emery, P. (1994) Arthritis and Rheumatism 37, 1166-1170.
11. Toda, Y., Morimoto, T., Akagi, S., Sugano, H., Mori, Y., Ochi, T. and Ogawa, R. (1995) American College of Rheumatology Abstracts. 249.

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