TORONTO  It will be very difficult now for an arthritis cure to continue to elude the more than 4 million Canadians affected by this debilitating disease. The search for new therapies and possible cures for arthritis are just some of the stated goals of the Canadian Arthritis Network (CAN), a new addition to the federal government¿s flagship Networks of Centres of Excellence (NCE) program. Launched in 1989, the program has received worldwide acclaim and constitutes an innovative approach to developing Canada¿s economy. Essentially, it creates research institutes without walls that link Canada¿s strengths in areas of importance to partners that can develop commercial opportunities. In its 1997 budget, the Canadian government recognized the program¿s success by making it permanent, with an investment of C$47.4 million a year.

The new arthritis network, which has been awarded C$14.5 million over four years, was established following a national competition. It brings the number of biotech/ health-related NCEs to five out of the current total of 14 networks.

Tony Cruz, CAN¿s program director, said the network represents more than 100 leading Canadian scientists and clinicians working together with the support of some 40 institutional and corporate partners. As such, the integrated network, combining the strengths of its members and partners, is designed to accelerate the application of medical strategies that prevent, diagnose or treat arthritis.

CAN will fund research and develop products by partnering with academic institutions, not-for-profit organizations, venture capitalists, biotechnology and pharmaceutical companies, as well as government agencies. CAN¿s goal is to eventually become a self-sufficient organization, Cruz said.

The network will also develop a core facility for arthritis information transfer and dissemination which will not only provide information to health care providers and people with arthritis but collect information from arthritis sufferers to more clearly understand their needs and develop research strategies to meet those needs.

¿If it can accelerate by even one year the development of cutting-edge therapies, then that¿s how it will help people with arthritis,¿ said Cruz, a senior scientist at the Samuel Lunenfeld Research Institute, of Toronto, and an associate professor at the University of Toronto.

What causes arthritis is unknown, although genetic and environmental factors have been implicated. Women appear to be particularly vulnerable to the major forms of arthritis.

Current therapies for arthritis provide symptomatic relief only, and in the long term do not modify significantly the course of the disease involving joint destruction and disability. The average mean time to discontinuation of disease-modifying anti-rheumatic therapy because of adverse effects or loss of efficacy is two to four years. These inadequacies are economically wasteful and have created a serious need for new agents and treatment modalities and assessment.

Scientific Critical Mass¿ Assembled

However, identification of effective therapeutic agents has been hampered by the absence of reliable molecular markers and diagnostic tools which can accurately document early disease phases and subsequent progression.

Cruz said that leading investigators have been recruited as network theme leaders and participants to conduct an R&D program in arthritis. The scientific ¿critical mass¿ is assembled to address the major disease processes involved in arthritis, particularly those that involve the joints; identify potential therapeutic and diagnostic strategies; and establish methodologies to evaluate current and emerging therapies.

The CAN research strategy will consist of five integrated themes and objectives: human genetics and inflammatory mediators in arthritis to identify potential genes and signaling pathways as targets for therapeutic intervention; cellular and molecular biology of joint tissues; bioengineering for joint reconstruction; diagnostics and therapeutics; and methodologies and outcomes to identify new techniques for assessing the risks/benefits of existing and emerging arthritis therapies, improve timely access to these interventions and refine outcomes and overall benefits. Highly skilled core facilities in clinical trials, outcomes measurement, animal models, diagnostics, genetics, transgenic models and physician/patient decision aids will facilitate the advancement of knowledge, development of products and rapid dissemination of information. In addition to assisting network members, these core services are expected to become profit centers, generating revenues by providing a wide range of services to the pharmaceutical and biotechnology sectors.

The arthritis society is adding a further C$3 million to the network to implement training of basic researchers and clinical scientists in arthritis. Partners in the pharmaceutical, biotech and information-technology sectors have already been identified to match this funding in order to attract talented investigators to arthritis research, said Denis Morrice, CEO of the society.

The scholarship funding will be administered by the network and will be available to candidates of demonstrated excellence so that they can collaborate with leading investigators in a networked environment, exposing them to the broad diversity of scientific disciplines involved in arthritis research.

With more than 4 million already affected by the chronic disease, the number of Canadians with arthritis is growing at a rate of 1 million per decade. The prevalence of arthritis disability is quickly doubling; it is estimated that it will affect up to 12 million people in Canada by 2030.

Baby boomers will be hardest hit. Between 1991 and 2021, the number of 45- to 54-year-olds diagnosed with arthritis will nearly double to 738,700 from 418,100, while the number of 55- to 64-year-olds with arthritis will more than double to 1.4 million from 645,900.

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