CINXE.COM

<!doctype html> <html lang="en"> <head>  <meta http-equiv="X-UA-Compatible" content="IE=edge"><script type="text/javascript" src="/cf_scripts/cfclient/cfclient_main.js"></script> <script type="text/javascript" src="/cf_scripts/cfclient/cffunctions.js"></script> <meta charset="utf-8"> <meta name="language" content="en"> <meta name="creator" content="Department of Veterans Affairs, Veterans Health Administration, Office of Chief Research and Development Officer"> <meta name="subject" content="Arthritis"> <meta name="keywords" content="VA ORD Research Topics, Arthritis"> <meta name="description" content="VA ORD Research Topics: Arthritis"> <meta property="article:published_time" content="#updateDate#" /> <meta name="type" content="General Information"> <title>Arthritis</title>  <link href="/css/2020-update.css" media="all" rel="stylesheet" type="text/css"> <link href="/css/VAMC-styles.css" media="all" rel="stylesheet" type="text/css"> <script type='text/javascript'> var _$mainheader_3_func = function(){ var self = this; var variables = {}; self.__init_3 = function () { var localdivstruct = globalDivStruct; var __output_var = ''; var tmpVarArray = {}; if((__$cf.__arrayGet(cfclient,"properties","width",true) <= 600)) { mobileSize = ('yes') ; localdivstruct.outputvar += " <link href=\"\/css\/mobile.css\" media=\"screen\" rel=\"stylesheet\" type=\"text\/css\"> "; localdivstruct.outputvar += " <a href=\"\/topics\/\">View all Research Topics pages<\/a> | <a href=\"\/default.cfm\">ORD Home Page<\/a> "; } return ''; } }; function __startPage__$mainheader_3() { document.write("<div id='__cfclient_3'></div>"); window.ispgbuild = false; setTimeout(function(){if(!cfclient.isCFClientReady()) throw "Your client-side CFML code has encountered an initialization error. The required plugins cannot be loaded successfully within the timeout period.";},10000); cfclient.init({loadAPIPlugin:false,loadDeviceDetectionPlugin:true,loadServerPlugin:false,enableDebugLog:false,ajaxScriptSrcPath:'cf_scripts/scripts/'}, function(){ var clientDivStruct = {divId:"__cfclient_3",outputvar:""}; globalDivStruct = clientDivStruct; try{ _$mainheader_3 = new _$mainheader_3_func(); _$mainheader_3.__init_3(); } catch (__eArg) { if (__eArg !== "$$$cfclient_abort$$$"){ throw __eArg; } } __$cf.__flush(clientDivStruct); } ); } __startPage__$mainheader_3(); </script>  <link href="/css/custom.css" media="all" rel="stylesheet" type="text/css"> <link href="/css/print.css" media="print" rel="stylesheet" type="text/css"> <link href="/css/VAMC-styles.css" media="all" rel="stylesheet" type="text/css"> <link href="/css/template_styles_edited.css" media="all" rel="stylesheet" type="text/css"> <link href="//www.va.gov/va_files/2012/styles/image_gallery.css" media="all" rel="stylesheet" type="text/css">  <link href="/css/slide-menu-ns.css" media="all" rel="stylesheet" type="text/css">  <link href="/css/slide-menu-custom.css" media="all" rel="stylesheet" type="text/css">  <link href="/css/tabs.css" media="all" rel="stylesheet" type="text/css">      <script src="/scripts/code.jquery.com_jquery-3.7.1.js" type="text/javascript"></script> <script src="/scripts/jquery-tools-min.js" type="text/javascript"></script> <script src="//www.va.gov/va_files/2012/scripts/tabs.js" type="text/javascript"></script> <script src="//www.va.gov/va_files/2012/scripts/script.js" type="text/javascript" ></script>  <script language="JavaScript" type="text/javascript"> function externalLink() { alert('This link leaves the VA Office of Research & Development website. The appearance of this hyperlink does not constitute endorsement by VA of this website or the information, products or services contained therein.'); } </script> <script async type="text/javascript" src="https://dap.digitalgov.gov/Universal-Federated-Analytics-Min.js?agency=VA" id="_fed_an_ua_tag"></script> <script type="text/javascript"> function toggle(id, id2) { var n = document.getElementById(id); if (n.style.display != 'none') { n.style.display = 'none'; document.getElementById(id2).setAttribute('aria-expanded', 'true'); } else { n.style.display = ''; document.getElementById(id2).setAttribute('aria-expanded', 'false'); } } </script> <script async type="text/javascript" src="/scripts/2013-left-nav.js"></script> <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css"> <meta name="viewport" content="width=device-width"> <script type="text/javascript" src="/cf_scripts/cfclient/jquery.js"></script> </head><body> <div id="skiplink"> <a href="#main-content">skip to page content</a></div> <div class="header"> <div class="usabanner"> <div class="usa-inner"> <div class="veteran-crisis-line" id="openVeteranCrisis"> <img class="va-crisis-line-arrow" src="https://prod-va-gov-assets.s3-us-gov-west-1.amazonaws.com/img/arrow-right-white.svg" aria-hidden="true" alt="Open Crisis Line info"> <span style="postion:relative; margin-left: 20px; font-size:15.5px; width: 300px; z-index: 1;">Talk to the <strong>Veterans Crisis Line</strong> now </span> </div> <img src="https://prod-va-gov-assets.s3-us-gov-west-1.amazonaws.com/img/tiny-usa-flag.png" height="19" alt="U.S. flag" style="float:left; margin-right:4px; padding-left: 10px;"><div style="width:520px!important; padding-top: 3px; font-size: 11px;" > An official website of the United States government <button style="font-size: 11px; border: 0px; background: #f1f1f1;" aria-controls="gov-banner" onclick="toggle('gov-banner', 'TLink1')" id="TLink1"><span class="usa-dropdown">Here's how you know <i onclick="myFunction(this)" class="fa fa-chevron-down"></i></span></button> </div> </div> <div id="gov-banner" aria-expanded="false" style="display: none;"> <div class="gov-banner-inner"> <div class="clear"><br><br></div> <div class="gov-banner-left"> <div style="float:left; margin-right: 10px; min-height: 80px;"><img src="https://prod-va-gov-assets.s3-us-gov-west-1.amazonaws.com/img/icon-dot-gov.svg" alt="Dot gov" width="40" height="40"></div> <div class="usa-media_block-body"> <p> <strong>The .gov means it's official.</strong> <br> Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. </p> </div> </div> <div class="gov-banner-right"> <div style="float:left; margin-right: 10px; min-height: 80px;"><img class="usa-banner-icon usa-media_block-img" src="https://prod-va-gov-assets.s3-us-gov-west-1.amazonaws.com/img/icon-https.svg" alt="SSL" width="40" height="40" ></div> <div> <p> <strong>The site is secure.</strong> <br> The <strong>https://</strong> ensures that you're connecting to the official website and that any information you provide is encrypted and sent securely. </p> </div> </div> <div class="clear"></div> </div> </div> </div> <div class="blueheader"> <div class="va-logo-header-wrapper"> <div class="va-logo-inner" style="float: left;"> <a href="https://www.va.gov" class="va-header-logo" target="_blank"> <img src="https://prod-va-gov-assets.s3-us-gov-west-1.amazonaws.com/img/header-logo.png" alt="Go to VA.gov" title="Go to VA.gov"> </a> </div> <div class="profile-nav" style="padding-top: 50px;"> <div class="searchdropdown" > <button onclick="searchdropdownFunction()" class="searchbutton"><i class="fa fa-search" style="color: white; font-size: 14px;"></i> Search ORD</button> <div id="searchDIV" class="searchDropdown-content"> <form accept-charset="UTF-8" action="https://search.usa.gov/search" id="search_form" method="get"> <div style="margin:0;padding:0;display:inline"> <input name="utf8" type="hidden" value="✓" /></div> <input id="affiliate" name="affiliate" type="hidden" value="va_ord" /> <label for="query">Enter Search Term(s):</label> <input autocomplete="off" class="usagov-search-autocomplete" id="query" name="query" type="text" /> <input name="commit" type="submit" value="Search" /> </form> </div> </div> <div class="contactDropdown"> <button class="contactbutton" formtarget="_blank" onClick="closeSearch(); parent.open('//www.va.gov/contact-us/')" value='click here to visit VA Contact Us page'><i class="fa fa-question-circle" style="color: white; font-size: 14px;"></i> Contact VA <i class="fa fa-external-link" style="color:white; font-size:10px;"></i></button> </div> <div style="clear:all;"></div> </div> </div> <div class="va-main-nav-header" style="border:0px solid yellow; height:50px;"> <div class="vatopnav" style="margin: 0 auto; width:960px; border-top:1px solid white;"> <a href="https://www.va.gov/" target="_blank">Veterans Benefits and Health Care <i class="fa fa-external-link" style="color:white; font-size:12px;"></i></a> <a href="https://www.va.gov/about_va/" target="_blank">About VA <i class="fa fa-external-link" style="color:white; font-size:12px;"></i></a> <a href="https://www.va.gov/find-locations/" target="_blank">Find a VA Location <i class="fa fa-external-link" style="color:white; font-size:12px;"></i></a> </div> </div> </div> </div> <div id="modal-crisisline" class="modal" role="alertdialog"><div class="modal-content"> <div class="modal-body"><span class="close">×</span><h1 class="modal-title">We're here anytime, day or night — 24/7</h1><p>If you are a Veteran in crisis or concerned about one, connect with our caring, qualified responders for confidential help. Many of them are Veterans themselves.</p><ul class="va-crisis-panel-list"><li><i class="fa fa-phone va-crisis-panel-icon" aria-hidden="true"></i> <a href="tel:18002738255">Call <strong>800-273-8255 and press 1</strong></a></li><li><i class="fa fa-mobile-alt va-crisis-panel-icon" aria-hidden="true"></i><a href="sms:838255">Text <strong>838255</strong></a></li><li><i class="fa fa-comments va-crisis-panel-icon" aria-hidden="true"></i> <a class="no-external-icon" href="https://www.veteranscrisisline.net/ChatTermsOfService.aspx?account=Veterans%20Chat">Start a confidential chat</a></li><li><i class="fa fa-deaf va-crisis-panel-icon" aria-hidden="true"></i> <a href="tel:18007994889">Call TTY if you have hearing loss <strong>800-799-4889</strong></a></li></ul><br> <br> <p>Get more resources at <a class="no-external-icon" href="https://www.veteranscrisisline.net/">VeteransCrisisLine.net</a>.</p> </div> </div></div> <script async type="text/javascript" src="/scripts/2020-update.js"></script>  <div id="bg-main"> <div id="bg-middle-effect"> <div id="site-wrapper">  <div> <div style="background-color:white;"> <div id="mainContentWrapper" style="width: 920px; height: 60px;"> <a name="content-wrapper" id="content-wrapper"></a>   <div id="breadCrumbPath" style="font-size: 11px!important;"> <a href="/default.cfm">ORD Home</a> » <a href="/topics">Topics</a>  » Arthritis </div>   <table border="0" cellpadding="0" cellspacing="0" width="100%" style="border:none !important; margin-bottom: 4px!important;"> <tr valign="top" style="border:none !important;"> <td valign="top" style="border:none !important;"><h1>Office of Research & Development</h1></td> <td valign="top" style="border:none !important;"> <script> function PrintPage() { window.print(); } </script> <img src="/images/print_icon2.gif" width="55" height="20" alt="print icon" align="right" style="cursor:pointer; " onClick="PrintPage()" target="_blank" /> <a href="https://public.govdelivery.com/accounts/USVHA/subscriber/new?topic_id=USVHA_702" target="_blank"><img src="/images/signup.gif" alt="sign up for VA Research updates" align="right"></a> <br></td> </tr> </table>  </div>  <div id="container" style="clear:both; min-height: 840px; "> <div id="leftNavContainer">  <div id="leftNav"> <nav> <ul class="accordion" style="margin-left:-5px; padding-top:0px;"> <li><a href="/default.cfm">ORD Home</a></li> <li><a href="#"><span></span>About Us</a> <ul class="sub-menu"> <li><a href="/about/default.cfm">Overview</a></li> <li><a href="/about/crado.cfm">Leadership</a></li> <li><a href="/about/strategic_priorities.cfm">Strategic Priorities</a></li> <li><a href="/about/strategic_plan.cfm">Strategic Plan</a></li> <li><a href="/about/budget.cfm">Annual Research Budget</a></li> <li><a href="#"><span></span>Funded VA Research Projects</a> <ul class="sub-sub-menu"> <li><a href="/about/funded_research/default.cfm">All</a></li> <li><a href="/about/funded_research/projects-FY2025.cfm">FY2025</a></li> <li><a href="/about/funded_research/projects-FY2024.cfm">FY2024</a></li> <li><a href="/about/funded_research/projects-FY2023.cfm">FY 2023</a></li> <li><a href="/about/funded-projects-FY2022.cfm">FY 2022</a></li> <li><a href="/about/funded_research/projects-FY2021.cfm">FY 2021</a></li> <li><a href="/about/funded_research/projects-FY2020.cfm">FY 2020</a></li> <li><a href="/about/funded_research/projects-FY2019.cfm">FY 2019</a></li> <li><a href="/about/funded_research/projects-FY2018.cfm">FY 2018</a></li> <li><a href="/about/funded_research/projects-FY2017.cfm">FY 2017</a></li> </ul> </li> <li><a href="/about/find_research_projects.cfm">Find VA Research Articles and Projects</a></li> <li><a href="/about/history.cfm">Historical Accomplishments</a></li> <li><a href="#"><span></span>Awards & Career Milestones</a> <ul class="sub-sub-menu"> <li><a href="/about/awards/default.cfm">Overview</a></li> <li><a href="/about/awards/all.cfm">All Awards</a></li> <li class="element-hidden"><a href="/about/awards/awardee.cfm">hidden</a></li> <li><a href="/isrm/shared_docs/pecase.cfm">PECASE Award</a></li> </ul> </li> <li><a href="/about/research_communications.cfm">VA Research Communications</a></li> <li><a href="/resources/ORD_Admin/ord_contacts.cfm">ORD Contact Information</a></li> <li><a href="/about/national_directory.cfm">ACOS/AO Directory</a></li> <li class="element-hidden"><a href="/about/national_directory_byCity.cfm">hidden</a></li> <li class="element-hidden"><a href="/about/national_directory_name.cfm">hidden</a></li> <li><a href="/about/employment.cfm">Employment</a></li> <li><a href="/about/fellowships.cfm">Fellowships</a></li> </ul> </li> <li><a href="#"><span></span>Programs</a> <ul class="sub-menu"> <li><a href="/programs/default.cfm">All Programs</a></li> <li><a href="#"><span></span>Investigators, Scientific Review, and Management</a> <ul class="sub-menu"> <li><a href="/isrm/default.cfm">Overview</a></li> <li><a href="#"><span></span>Actively Managed Portfolios</a> <ul class="sub-sub-menu"> <li><a href="/isrm/amp/default.cfm">Overview</a></li> <li><a href="/isrm/amp/military_exposures.cfm">Military Exposures</a></li> <li><a href="/isrm/amp/pain_opiod.cfm">Pain and Opioid Use</a></li> <li><a href="#"><span></span>Precision Oncology</a> <ul class="sub-sub-menu"> <li><a href="/isrm/amp/precision_oncology/default.cfm">Overview</a></li> <li><a href="/isrm/amp/precision_oncology/lpop.cfm">Lung Cancer</a></li> <li><a href="/isrm/amp/precision_oncology/popcap.cfm">Prostate Cancer</a></li> <li> <a href="/isrm/amp/precision_oncology/compl.cfm">Computer Vision and Machine Learning in Precision Oncology</a></li> </ul> </li> <li><a href="/isrm/amp/suicide_prevention.cfm">Suicide Prevention</a></li> </ul> </li> <li><a href="#"><span></span>Broad Portfolios</a> <ul class="sub-sub-menu"> <li><a href="/isrm/broad_portfolios.cfm">Overview</a></li> <li><a href="#"><span></span>Brain, Behavioral and Mental Health </a>  <ul class="sub-sub-menu"> <li><a href="/isrm/csrd/default.cfm">Overview</a></li> <li><a href="/isrm/csrd/barnwell.cfm">Barnwell Award</a></li> <li><a href="/isrm/shared_docs/career_dev.cfm">Career Development</a></li> <li><a href="/isrm/csrd/confidentiality.cfm">Certificates of Confidentiality</a></li> <li><a href="/isrm/csrd/biospecimens-collection.cfm">Collection of Biospecimens</a></li> <li><a href="/isrm/csrd/contacts.cfm">Contacts</a></li> <li><a href="/isrm/csrd/csp.cfm">Cooperative Studies Program (CSP)</a></li> <li><a href="/isrm/csrd/newsletter/default.cfm">CSRD Newsletter</a></li> <li><a href="/isrm/csrd/data-monitoring.cfm">Data Monitoring</a></li> <li><a href="/isrm/csrd/nonveterans.cfm">Enrollment of Non-Veterans</a></li> <li><a href="/isrm/csrd/director.cfm">Leadership</a></li> <li><a href="/isrm/csrd/merit_review.cfm">Merit Review</a></li> <li><a href="/isrm/csrd/ppi.cfm">PTSD Psychopharmacology Initiative</a></li> <li><a href="/isrm/shared_docs/rcs_awards.cfm">Research Career Scientist</a></li> <li><a href="/isrm/csrd/sheep.cfm">ShEEP</a></li> <li><a href="#"><span></span>VA CURES</a> <ul class="sub-sub-menu"> <li><a href="/isrm/csrd/va_cures/default.cfm">Overview</a> <li><a href="/isrm/csrd/va_cures/va-cures-1.cfm">VA CURES-1</a> </ul> </li> </ul> </li>  <li><a href="/isrm/hsrd.cfm">Health Systems Research</a></li> <li><a href="#"><span></span>Medical Health</a> <ul class="sub-sub-menu"> <li><a href="/isrm/blrd/default.cfm">Overview</a></li> <li><a href="/isrm/shared_docs/career_dev.cfm">Career Development</a></li> <li><a href="/isrm/blrd/clinician_bridge.cfm">Clinician Bridge Funding</a></li> <li><a href="/isrm/blrd/csi.cfm">Clinician Scientist Investigator Award</a> </li> <li><a href="/isrm/blrd/contacts.cfm">Contacts</a></li> <li><a href="/isrm/blrd/dmrs.cfm">Distinguished Medical Research Scientist</a></li> <li><a href="/isrm/blrd/director.cfm">Leadership</a></li> <li><a href="/isrm/blrd/merit_review.cfm">Merit Review</a></li> <li><a href="/isrm/blrd/middleton.cfm">Middleton Award</a></li> <li><a href="/isrm/blrd/notable_investigators.cfm">Notable Investigators</a></li> <li><a href="/isrm/shared_docs/rcs_awards.cfm">Research Career Scientist</a></li> <li><a href="/isrm/blrd/sheep.cfm">ShEEP</a></li> </ul> </li> <li><a href="/isrm/rrd.cfm">Rehabilitation Research, Development and Translation</a></li> </ul> </ul> </li> </li> <li><a href="/programs/enterprise_optimization.cfm">Enterprise Optimization</a></li> <li><a href="#"><span></span>Enterprise Protections, Regulatory, Outreach, and Systems</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/default.cfm">Overview</a></li> <li><a href="/programs/epros/findpro.cfm">FIND Pro</a></li> <li><a href="/programs/epros/policies.cfm">Human Subjects Research Policies and Guidance</a></li> <li><a href="/programs/epros/privacy_officer.cfm">ORD Privacy Officer</a></li> <li><a href="/programs/ePROS/animal_research.cfm">Animal Research</a></li> <li><a href="#"><span></span>Research Education and Training</a> <ul class="sub-sub-menu"> <li><a href="/programs/ePROS/education/default.cfm">Overview</a></li> <li><a href="/programs/ePROS/education/ord_training/researcher_training.cfm">Researcher Training</a></li> <li><a href="/programs/ePROS/education/ord_training/committee-members.cfm">Committee Member Training</a></li> </li> <li><a href="/programs/ePROS/education/citi.cfm">CITI Administration</a></li> <li><a href="#"><span></span>Webinars</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/education/webinars/default.cfm">Upcoming</a></li> <li><a href="/programs/epros/education/webinars/archives.cfm">Past Sessions</a> </li> </ul> </li> </ul> </li> <li><a href="/programs/epros/regulatory.cfm">Research Policy and Regulatory</a></li> <li><a href="#"><span></span>VA Central IRB</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/vacentralirb/default.cfm">Overview</a></li> <li><a href="/programs/epros/vacentralirb/administration.cfm">Administration</a></li> <li><a href="/programs/epros/vacentralirb/irb_submissions.cfm">IRB Submissions</a></li> <li><a href="/programs/epros/vacentralirb/facility_nformation.cfm">Facility Information</a></li> <li><a href="/programs/epros/vacentralirb/sop.cfm">Standard Operating Procedures</a></li> <li><a href="/programs/epros/vacentralirb/roster.cfm">VA CIRB Membership and Meetings</a></li> <li><a href="/programs/epros/vacentralirb/resources.cfm">Resources</a></li> </ul> </li> </li> <li><a href="#"><span></span>Other IRB Information</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/irb_relationships.cfm">IRB Relationships in the VA</a></li> <li><a href="/programs/epros/nci_irb.cfm">NCI IRB Information</a></li> <li><a href="/programs/epros/CDC-IRB-TPOXX-EAIND-Program.cfm">CDC IRB TPOXX EAIND Program</a></li> </ul> </li> <li><a href="#"><span></span>VA Innovation and Research Review System (VAIRRS) </a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/vairrs/default.cfm">About Us</a></li> <li><a href="/programs/epros/vairrs/data.cfm">Data Shoutouts</a></li> <li><a href="/programs/epros/vairrs/ambassador.cfm">Ambassador Program</a></li> <li><a href="/programs/epros/vairrs/vepa.cfm">Enterprise Partnership Award</a></li> <li><a href="/programs/epros/vairrs/faq.cfm">FAQs</a></li> <li><a href="/programs/epros/vairrs/did-you-know.cfm">Did You Know?</a></li> <li><a href="/programs/epros/vairrs/dashboards.cfm">Dashboards</a></li> <li><a href="#"><span></span>Training</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/vairrs/training/default.cfm">Training Opportunities</a></li> <li><a href="/programs/epros/vairrs/training/training_resources.cfm">Training Resources</a></li> <li><a href="/programs/epros/vairrs/training/irbnet-topics.cfm">IRBNet Topics</a></li> <li><a href="/programs/epros/vairrs/training/vaiirs_university.cfm">VAIRRS University</a></li> <li><a href="/programs/epros/vairrs/training/webinars.cfm">VAIRRS Webinars</a></li> </ul> </li> <li><a href="/programs/epros/vairrs/newsletter/default.cfm">VAIRRS News</a></li> <li><a href="/programs/epros/vairrs/contact.cfm">Contact</a></li> </ul> </li> <li><a href="#"><span></span>VA Electronic Determination Aid (VAEDA)</a> <ul class="sub-sub-menu"> <li><a href="/programs/epros/vaeda.cfm">Overview</a></li> <li><a href="/programs/epros/vaeda-faq.cfm">FAQs</a></li> </ul> </li> </ul> </li> <li><a href="/programs/other.cfm">Other Programs</a></li> </ul> </li> <li><a href="#"><span></span>News and Publications</a> <ul class="sub-menu"> <li><a href="/pubs/default.cfm">Overview</a></li> <li><a href="#"><span></span>VA Research Currents</a> <ul class="sub-sub-menu"> <li><a href="/currents/default.cfm">Recent Articles</a></li> <li><a href="/currents/archive.cfm">Archive</a></li> </ul> </li> <li><a href="/in_brief.cfm">News Briefs</a></li> <li><a href="/pubs/ord-history.cfm">VA Research: A Historical Look</a></li> <li><a href="/pubs/pubs_individual.cfm?Category=Gulf%20War%20Reports">Gulf War Reports</a></li> <li><a href="/pubs/brochures.cfm">Brochures for Print</a></li> <li><a href="/pubs/order_brochure.cfm">Order Brochures</a></li> <li><a href="/events.cfm">Events</a></li> <li><a href="#"><span></span>Research Week</a> <ul class="sub-menu"> <li><a href="/researchweek/default.cfm">Overview</a></li> <li><a href="/researchweek/resources.cfm">Resources</a></li> <li><a href="/researchweek/kickoff.cfm">2024 Kickoff Event</a></li> <li><a href="/researchweek/kickoff-2023.cfm">2023 Kickoff Event</a></li> <li><a href="/researchweek/future-dates.cfm">Future Dates</a></li> <li><a href="/researchweek/contacts.cfm">Contact</a></li> </ul> </li> </ul> </li> <li><a href="#"><span></span>Research Topics</a> <ul class="sub-menu"> <li><a href="/topics/default.cfm">All Topics</a></li> <li><a href="/topics/oef-oif.cfm">Afghanistan & Iraq</a></li> <li><a href="/topics/alzheimers.cfm">Alzheimer's Disease and Related Dementias</a></li> <li><a href="/topics/arthritis.cfm">Arthritis</a></li> <li><a href="/topics/cancer.cfm">Cancer</a></li> <li><a href="/topics/cardio.cfm">Cardiovascular Disease</a></li> <li><a href="/topics/caregivers.cfm">Caregivers</a></li> <li><a href="/topics/cih.cfm">Complementary and Integrative Health</a></li> <li><a href="/topics/covid-19.cfm">COVID-19</a></li> <li><a href="/topics/depression.cfm">Depression</a></li> <li><a href="/topics/diabetes.cfm">Diabetes</a></li> <li><a href="/topics/gastro.cfm">Gastrointestinal Health</a></li> <li><a href="/topics/genomics.cfm">Genomics</a></li> <li><a href="/topics/gulfwar.cfm">Gulf War Veterans</a></li> <li><a href="/topics/healthcare_delivery.cfm">Health Care Delivery</a></li> <li><a href="/topics/health_equity.cfm">Health Equity</a></li> <li><a href="/topics/hearing.cfm">Hearing Loss</a></li> <li><a href="/topics/hep-c.cfm">Hepatitis C</a></li> <li><a href="/topics/homelessness.cfm">Homelessness</a></li> <li><a href="/topics/infectious_diseases.cfm">Infectious Diseases</a></li> <li><a href="/topics/informatics.cfm">Informatics</a></li> <li><a href="/topics/kidney_disease.cfm">Kidney Disease</a></li> <li><a href="/topics/mental_health.cfm">Mental Health</a></li> <li><a href="/topics/multiple_sclerosis.cfm">Multiple Sclerosis</a></li> <li><a href="/topics/obesity.cfm">Obesity</a></li> <li><a href="/topics/pain.cfm">Pain Management</a></li> <li><a href="/topics/parkinsons.cfm">Parkinson's Disease</a></li> <li><a href="/topics/ptsd.cfm">Posttraumatic Stress Disorder (PTSD)</a></li> <li><a href="/topics/prosthetics.cfm">Prosthetics</a></li> <li><a href="/topics/respiratory.cfm">Respiratory Health</a></li> <li><a href="/topics/rural_health.cfm">Rural Health</a></li> <li><a href="/topics/sci.cfm">Spinal Cord Injury</a></li> <li><a href="/topics/sud.cfm">Substance Use Disorders</a></li> <li><a href="/topics/suicide.cfm">Suicide Prevention</a></li> <li><a href="/topics/tbi.cfm">Traumatic Brain Injury (TBI) </a></li> <li><a href="/topics/vietnam.cfm">Vietnam Veterans</a></li> <li><a href="/topics/visionloss.cfm">Vision Loss</a></li> <li><a href="/topics/womens_health.cfm">Women's Health</a></li> </ul> </li> <li><a href="#"><span></span>For Veterans</a> <ul class="sub-menu"> <li><a href="/for_veterans/default.cfm">Joining a Research Study</a></li> <li><a href="/for_veterans/volunteering-faq.cfm">Research Participation FAQ</a></li> <li><a href="/for_veterans/safeguarding_vets.cfm">Safeguarding Information</a></li> <li><a href="/for_veterans/find_studies.cfm">Find VA-sponsored clinical trials near you</a> </li> <li><a href="#"><span></span>VA Research in Action</a> <ul class="sub-sub-menu"> <li><a href="/research_in_action/default.cfm">All Summaries</a></li> </ul> </li> </ul> </li> <li><a href="#"><span></span>For VA Research Community</a> <ul class="sub-menu"> <li><a href="/resources/default.cfm">Overview</a></li> <li><a href="#"><span></span>Funding</a> <ul class="sub-sub-menu"> <li><a href="/funding/default.cfm">Funding Home</a></li> <li><a href="/funding/electronic-submission.cfm">Electronic Submission</a></li> <li><a href="/funding/rfa.cfm">Notices of Special Interest and Requests for Applications</a></li> <li><a href="/funding/cdp.cfm">Career Development</a></li> <li><a href="/funding/diversity.cfm">Diversity</a></li> <li><a href="/funding/jit.cfm">Just-In-Time Process (JIT)</a></li> </ul> </li> <li><a href="#"><span></span>Policies and Guidance</a> <ul class="sub-menu"> <li><a href="/resources/policies/default.cfm">Overview</a></li> <li><a href="/resources/policies/general_admin.cfm">General Administration</a></li> <li><a href="/resources/policies/research.cfm">Research</a></li> <li><a href="/resources/policies/faq-search.cfm">Research FAQs</a></li> <li><a href="/resources/policies/human_resources/default.cfm">Human Resources</a></li> <li><a href="/resources/policies/outside_compensation.cfm">Outside Compensation</a></li> <li><a href="/resources/policies/handbooks.cfm">ORD Program Guides, VHA Directives, Handbooks</a></li> <li><a href="/resources/policies/pub_notice.cfm">Publication Notification</a></li> <li><a href="/resources/policies/public_access.cfm">NIH Manuscript Submission for VA Investigators</a></li> </ul> </li> <li><a href="/resources/centralized_positions.cfm">Centralized Positions (GS-14 & Above)</a></li> <li><a href="/resources/RPPR.cfm">Federal-wide Research Performance Progress Report</a></li> <li><a href="/resources/ssn.cfm">SSN Data Requests</a></li> <li><a href="/resources/oasc.cfm">Conducting Staff Surveys</a></li> <li><a href="/resources/sig.cfm">Special Interest Groups</a></li> <li><a href="/resources/va-npc-affiliate-toolkit.cfm">VA/NPC/Affiliate Collaboration Toolkit</a></li> <li><a href="#"><span></span>ORD Admin Resources</a> <ul class="sub-sub-menu"> <li><a href="/resources/ORD_Admin/default.cfm">Admin Resources Home</a></li> <li><a href="/resources/ORD_Admin/ord_contacts.cfm">Central Office Contacts</a></li> <li><a href="/resources/ORD_Admin/clinical_trials.cfm">Clinical Trials Registration and Submission</a></li> <li><a href="/resources/ORD_Admin/congressional_info.cfm">Congressional Requests</a></li> <li><a href="/resources/ORD_Admin/field_conference.cfm">Field Conference Calls</a></li> <li><a href="/resources/frac/default.cfm">Field Research Advisory Committee</a></li> </ul> </li> </ul> </nav> </div>   <div id="left-col-content"> </div>   </div>   <div id="innerContentWrapper" style="position: relative; "> <div class="clear"></div> <span style="position:absolute;"><a name="main-content" id="main-content"></a></span> <div class="clear"></div> <div id="innerContent" style="position:relative; ">  <h3> <em>Overview of VA research on</em></h3> <h2 style="font-size: 1.65em;" class="page-title">Arthritis</h2>  <div width="400px" style="border-radius:10px; border: 1px solid black; padding:14px!important;"> <ul> <li> <a href="#intro">Introduction</a></li> <li> <a href="#major">Selected Major Accomplishments in VA Research</a></li> <li style="font-size:12px"> <a href="#research">New, Ongoing, and Published Research</a> <ul> <li style="font-size:12px"> <a href="#research1">New treatments for arthritis</a></li> <li style="font-size:12px"> <a href="#research2">Complementary and integrative medicine treatments</a></li> <li style="font-size:12px"> <a href="#research3">Possible causes of arthritis </a></li> <li style="font-size:12px"> <a href="#research4"> Possible causes of arthritisCauses of death in patients with rheumatoid arthritis</a></li> </ul> </li> <li style="font-size:12px"> <a href="#more">More on Our Website</a></li> <li style="font-size:12px"> <a href="#articles">Selected Scientific Articles by Our Researchers</a></li> </ul> </div> <br>  <h2 id="intro">Introduction</h2> <p>Arthritis affects 52.5 million American adults, one in every five. According to the <a href="http://www.cdc.gov/arthritis/" target="_blank" onClick="externalLInk ()">Centers for Disease Control and Prevention</a>, it is the nation's most common cause of disability.</p> <p>Although the word arthritis actually means joint inflammation, the term is used to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues that surround the joint, and other connective tissue. The pattern, severity, and location of symptoms can vary, depending on the specific form of the disease.</p> <p>Typically, pain and stiffness in and around one of the joints characterize rheumatic conditions. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.</p> <p>Osteoarthritis, or degenerative joint disease, is the most common form of arthritis. According to the Arthritis Foundation, osteoarthritis affects up to 27 million Americans. Most of them are elderly.</p> <p>Scientists once thought the disease resulted from years of use of the joints; now they are exploring a complex web of biological factors that may contribute to the breakdown of cartilage.</p> <p>Rheumatoid arthritis (RA) affects about 1.3 million Americans. In this disease, the body's immune system attacks its own joint tissue, causing inflammation. RA can result in the destruction of cartilage and bone. Because damage begins early in the disease process, early diagnosis and treatment are important.</p> <p>A 2013 Centers for Disease Control study <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6344a4.htm">estimates</a> that one in four Veterans (25.6%) have arthritis, and that arthritis is more prevalent among Veterans than non-Veterans in all socio-demographic categories, including sex, age, fitness levels, employment status, and household income.</p> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h2 id= "major">Selected Major Accomplishments</h2> <ul> <li><b>2002:</b> Established the <a href="http://www.fedprac.com/home/article/insights-and-implications-of-the-va-rheumatoid-arthritis-registry/ocregister.html" target="_blank" onclick="externalLink ()">Rheumatoid Arthritis Registry</a>, providing researchers with access to information about hundreds of male patients with rheumatoid arthritis</li> <li><b>2006:</b> <a href="http://www.ncbi.nlm.nih.gov/pubmed/16495392" target="_blank" onclick="externalLink ()">Found</a> little overall benefit in two widely used nutritional supplements for arthritis (glucosamine and chondroitin sulfate)</li> <li><b>2011:</b> <a href="http://www.ncbi.nlm.nih.gov/pubmed/22057346" target="_blank" onclick="externalLink ()">Learned</a> that the complement system, a group of proteins that move freely through the blood stream, plays an important role in the development and spread of osteoarthritis</li> <li><b>2014:</b> Received the <a href="http://www.arthritis.org/arthritis-cure/for-researchers/howley-prize-for-arthritis-research/" target="_blank" onclick="externalLink ()">Lee C. Howley Sr. Prize for Arthritis Scientific Research</a> (VA Boston Health Care System and others) for determining that less expensive anti-rheumatic drugs worked as well as newer, more expensive, biological treatments</li> <li><b>2014:</b> <a href="http://www.ncbi.nlm.nih.gov/pubmed/24757150" target="_blank" onclick="externalLink ()">Tested</a> an anti-inflammatory drug on mice that may someday have the effect of reversing bone loss in patients with RA</li> </ul> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h2 id="research">New, Ongoing, and Published Research</h2> <p>VA researchers are developing new clinical treatments that reduce Veterans' disabilities and improve the ability of VA clinicians to provide effective care for patients with arthritis.</p> <p>Some groups are identifying molecular mechanisms that affect skeletal health and can lead to new treatments for osteoarthritis. Others are using innovative techniques to design therapeutic interventions, from surgical techniques to physical therapy, for patients who have lost mobility or functioning. Still others hope to halt the progression of osteoarthritis, and to reverse the degeneration of cartilage associated with the disease.</p> <h3 id="research1">➤ New treatments for arthritis</h3> <p><strong>Disease-modifying anti-rheumatic drugs vs biological treatments—</strong>In 2013, a team of researchers with VA and the University of Nebraska <a href="http://www.ncbi.nlm.nih.gov/pubmed/23755969" target="_blank" target="_blank" onclick="externalLink ()">found</a> that combinations of relatively inexpensive disease-modifying anti-rheumatic drugs produced the same clinical benefits as far more expensive biological treatment.</p> <p>The study included 353 patients at 16 VA medical centers, 12 rheumatoid arthritis investigational network sites, and eight Canadian medical centers. </p> <p>In 2014, the team of investigators conducting this study received the <a href="http://www.arthritis.org/arthritis-cure/for-researchers/howley-prize-for-arthritis-research/" target="_blank" onclick="externalLink ()">Lee C. Howley Sr. Prize for Arthritis Scientific Research</a> from the National Arthritis Foundation. The award is given each year to a study team that has "significantly advanced understanding, treatment, or prevention of arthritis and related disease," and whose work "will lead to a faster cure."</p> <p><strong>Disease-modifying anti-rheumatic drugs vs biological treatments—</strong>A 2014 VA <a href="http://www.ncbi.nlm.nih.gov/pubmed/24757150" target="_blank" onclick="externalLink ()">study</a> suggested that by using an anti-inflammatory drug to block a specific receptor (CD28) on T cells, bone loss related to RA might be halted, or even reversed. T cells are a type of lymphocyte (a white blood cell) that plays a central role in the immune system.</p> <p>The team, from the Atlanta VA Medical Center and Emory University School of Medicine studied the effects of a drug called CTLA-4-lg on mice, and found that the drug increased bone density by increasing new bone formation, rather than reducing the rate at which bones broke down. Their study may eventually lead to effective regenerative measures to repair damaged bone in the body's skeleton.</p> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h3 id="research2">➤ Complementary and integrative medicine treatments</h3> <p><strong>Nutritional supplements—</strong>In 2006, a nationwide clinical <a href="http://www.ncbi.nlm.nih.gov/pubmed/16495392" target="_blank" target="_blank" onclick="externalLink ()">trial</a> led by a VA investigator found little overall benefit for the widely used nutritional supplements glucosamine and chondroitin sulfate. The study's findings did suggest, however, that the supplements, taken in combination, might help those with more severe pain.</p> <p>The trial was supported by the National Institutes of Health and involved nearly 1,600 patients with osteoarthritis of the knee.</p> <p>On a related note, researchers <a href="http://www.ncbi.nlm.nih.gov/pubmed/21706174" target="_blank" target="_blank" onclick="externalLink ()">found</a> that participants in a study who used glucosamine for a long time developed fewer cases of lung cancer than others their age who did not take the supplement. No such relationship was found for chondroitin sulfate, however.</p> <p><strong>Swedish massage treatment for osteoarthritis—</strong>In a small pilot <a href="http://www.ncbi.nlm.nih.gov/pubmed/25966332" target="_blank" onclick="externalLink ()">study,</a> published in 2015, researchers from the Durham (North Carolina) VA Medical Center and Duke University demonstrated that Swedish massage is an acceptable and feasible treatment for VA health care users with osteoarthritis of the knee. </p> <p>The Veterans who took part in the study reported, on average, about a 30 percent improvement in pain, stiffness, and function. They did not, however, show improvement in a timed 50-foot walk. A larger clinical trial is planned.</p> <p><strong>Activity pacing—</strong>Ann Arbor VA researchers, with funding from the National Institutes of Health, are currently conducting a <a href="http://www.grantome.com/grant/NIH/I01-RX000410-01" target="_blank" target="_blank" onclick="externalLink ()">trial</a> that tests activity pacing in people with osteoarthritis. Activity pacing is a strategy to plan rest breaks during the day, which helps to avoid arthritis flare-ups. A pilot study has indicated that tailored activity pacing like this reduces fatigue and makes daily activities easier.</p> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h3 id="research3">➤ Possible causes of arthritis</h3> <p><strong>Immune-system changes—</strong>In 2011, VA and Stanford University researchers provided new <a href="http://www.ncbi.nlm.nih.gov/pubmed/22057346" target="_blank" target="_blank" onclick="externalLink ()">insights</a> into immune-system changes that may trigger the breakdown of cartilage associated with osteoarthritis. They found that the complement system, a group of proteins that move freely through the bloodstream, plays an important role in osteoarthritis' development and its spread.</p> <p>One component of the complement system, called the membrane attack complex, or MAC, is formed and activated in the joints of both humans and mice affected by osteoarthritis.</p> <p>The research team believes that when the MAC is activated incorrectly in the joints, it induces both low-grade inflammation and the productions of enzymes that break down cartilage and result in the development of osteoarthritis. This finding could eventually transmit into better therapies to treat the disease—or to prevent it altogether.</p> <p><strong>PTSD and autoimmune disorders—</strong>A 2015 <a href="http://www.ncbi.nlm.nih.gov/pubmed/25104173" target="_blank" onclick="externalLink ()">study</a> of more than 666,000 Veterans of Iraq and Afghanistan found that those with PTSD were more likely to have autoimmune disorders such as RA. The study, led by researchers at the San Francisco VA Medical Center, found a twofold increased risk of such disorders among those with PTSD compared with those who had no psychiatric disorders, and an even greater risk compared with those who had other psychiatric disorders than PTSD.</p> <p>Other autoimmune disorders these Veterans were at increased risk of developing included multiple sclerosis, lupus, inflammation of the thyroid, and inflammatory bowel disease. The study did not show that PTSD causes autoimmune disease, only that there is a relationship between the two conditions.</p> <h3 id="research4">➤ Causes of death in patients with rheumatoid arthritis</h3> <p>Researchers at the VA Nebraska-Western Iowa Health Care System <a href="http://www.ncbi.nlm.nih.gov/pubmed/26097231" target="_blank" onclick="externalLink ()">found</a>, in 2015, that men with RA have double the risk of death from all causes, and triple the rate of death from respiratory-related causes compared to the general population without RA.</p> <p>Cardiovascular-disease related mortality was the leading cause of death among the 332 deaths of 1,652 Veterans with RA who attended rheumatology clinics at twelve VA medical centers. The average age of those studied was 64.6 years. RA itself was the cause of 5.4 percent of the deaths. Further studies are needed to find out whether targeting these illnesses might lead to improved long-term survival in men with RA. </p> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h2 id="more">More on Our Website</h2> <ul><li><a href="http://www.rehab.research.va.gov/cent/paloalto.html" target="_blank">Bone and Joint Rehabilitation Center of Excellence</a></li> <li><a href="/currents/fall2014/fall2014-21.cfm">Boning up: Lab tests show promise for bone-regenerating injection</a>, <i>VA Research Currents</i>, Fall 2014</li> <li><a href="/currents/fall2014/fall2014-27.cfm">VA rheumatoid arthritis trial earns Howley Prize</a>, <i>VA Research Currents</i>, Fall 2014</li> <li><a href="/currents/fall2014/fall2014-11.cfm">PTSD tied to autoimmune disorders</a>, <i>VA Research Currents</i> fast findings, Oct. 21, 2014</li> <li><a href="/currents/0715-2.cfm">Pilot study with 25 Veterans yields promising results on Swedish massage for knee pain,</a> <i>VA Research Currents</i> journal scan, July 1, 2015</li> </ul> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> <h2 id="articles">Selected Scientific Articles by Our Researchers</h2> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/16495392" target="_blank" onclick="externalLink ()">Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis</a>. Clegg DO, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, Bradley JD, Bingham CO 3<sup>rd</sup>, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW, Schumacher HR Jr., Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJ. Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. N Engl J Med. 2006 Feb 23;354(8):795-808.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/22057346" target="_blank" onclick="externalLink ()">Identification of a central role for complement in osteoarthritis</a>. Wang Q, Rozelle AL, Lepus CM, Scanzello CR, Song JJ, Larsen DM, Crish JF, Bebek G, Ritter SY, Lindstrom TM, Hwang I, Wong HH, Punzl L, Encarnation A, Shamloo M, Goodman SB, Wyss-Coray T, Goldring SR, Banda NK, Thurman JM, Gobezie R, Crow MK, Holers VM, Lee DM, Robinson WH. Dysregulation of complement in synovial joints has a key role in the pathogenesis of osteoarthritis. Nat Med, 2011 Nov 6;17(12):1674-9.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/22740431" target="_blank" onclick="externalLink ()">Prospective study of posttraumatic stress disorder and disease activity outcomes in US Veterans with rheumatoid arthritis </a>. Mikuls TR, Padala PR, Sayles HR, Yu F, Michaud K, Caplan L, Kerr GS, Reimold A, Cannon GW, Richards JS, Lazaro D, Thiele GM, Boscarino JA. PTSD, along with other anxiety/depression disorders, may affect rheumatoid arthritis disease activity assessments that rely on patient-reported outcomes and the resulting treatment decisions. Arthritis Care Res (Hoboken.) 2013 Feb;6592):227-34.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/23755969" target="_blank" onclick="externalLink ()">Therapies for active rheumatoid arthritis after methotrexate failure</a>. O'Dell JR, Mikuls TR, Taylor TH, Ahluwalia V, Brophy M, Warren SR, Lew RA, Cannella AC, Kunkel G, Phibbs CS, Anis AH, Leatherman S, Keyston E, for the CSP 551 RACAT investigators. The use of less-expensive combination disease-modifying anti-rheumatic drugs produced the same clinical benefits as much more expensive biological treatment. N Engl J Med 2013;369:307-318, July 25, 2013</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/24757150" target="_blank" onclick="externalLink ()">CTLA-4lg-induced T cell anergy promotes Wnt-10b production and bone formation in a mouse model</a>. Roser-Page S, Vikulina T, Zayzafoon M, Weitzmann MN. Bone loss associated with RA and multiple other diseases may be stopped, and possibly even reversed, by suppressing CD28 signals to T cells. Arthritis Rheumatol. 2014 Apr;66(4):990-9.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/25609412" target="_blank" onclick="externalLink ()">Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration.</a>Navarro-Millan I, Yang S, DuVall SL, Chen L, Baddley J, Cannon GW, Delzell ES, Zhang J, Safford MM, Patkar NM, Mikuls TR, Singh JA, Curtis JR. In an older male cohort with RA, there was no clear association between low-density lipoprotein cholesterol and stroke, whereas higher levels of high-density lipoprotein cholesterol was inversely associated with heart attacks and stroke. Ann Rheum Dis. 2015 Jan 21. </p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/25104173" target="_blank" onclick="externalLink ()">Elevated risk for autoimmune disorders in Iraq and Afghanistan Veterans with posttraumatic stress disorder</a>. O'Donovan A, Cohen BE, Seal KH, Bertenthal D, Margaretten M, Nishimi K, Neylan TC. Trauma exposure and PTSD may increase the risk of autoimmune disorders such as rheumatoid arthritis. Biol Psychiatry, 2015 Feb 15;77(4):365-74.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/25966332" target="_blank" onclick="externalLink ()">Pilot study of massage in Veterans with knee osteoarthritis</a>. Juberg M, Jerger KK, Allen KD, Dmitrieva NO, Keever T, Perlman AI. This pilot study's results support the feasibility and acceptability of Swedish massage among VA health care users, and provides preliminary data suggesting its efficacy in reducing pain due to knee osteoarthritis. J Altern Complement Med. 2015 Jun; 21(6):333-8.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/26097231" target="_blank" onclick="externalLink ()">Cause-specific mortality in US Veteran men with rheumatoid arthritis</a>. England, BR, Sayles H, Michaud K, Caplan L, Davis LA, Cannon GW, Sauer BC, Solow EB, Reimold AM, Kerr GS, Schwab P, Baker JF, Mikuls TR. Men in this RA cohort experienced increased all-cause and cause-specific mortality, with a 3-fold risk of respiratory-related deaths compared to age-matched men in the general population. Arthritis Care Res (Hoboken). 2015 Jun 19. (Epub ahead of print.)</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/26586865" target="_blank" onclick="externalLink ()">Group versus individual physical therapy for Veterans with knee osteoarthritis: results of a randomized clinical trial</a>. Allen KD, Bongiorni D, Bosworth HB, Coffman CJ, Datta SK, Edelman D, Hall KS, Lindquist JH, Oddone EZ, Hoenig H. Group physical therapy and individual physical therapy were equally effective for patients with knee osteoarthritis. Either therapy may be a reasonable delivery model for health care systems to consider. Phys Ther. 2015 Nov 19. (Epub ahead of print.)</p> <p style= "text-align:right; margin-bottom: 0px; margin-top: 5px; color:#385f90; border-bottom:dotted 1px #385f90; font-size: 12px;"><a href="#top">top</a></p> </div>   <div id="tier4RightContent" style="position: absolute; right: 0px; padding-top: 0px; "> <div id="innerRightContent"> <div class="rightcol_box"> <h4>Arthritis Fact Sheet</h4> <a href="/pubs/docs/va_factsheets/Arthritis.pdf" target="_blank"><img alt="fact sheet thumbnail" src="/images/fact_sheets/Arthritis.jpg" width="150" height="195"><br> <p> Download PDF </p></a> </div>  <div class="rightcol_box"> <h4>Related Articles</h4> <p style="font-size:12px; margin-right:10px; margin-left:10px"> <a href="/currents/0424-VA-opens-new-research-center-to-seek-novel-arthritis-treatments.cfm"><img alt="thumbnail" src="/images/research-currents/create-opening-sm.jpg" width="165" alt="VA opens new research center to seek novel arthritis treatments">VA opens new research center to seek novel arthritis treatments</a> </p> <p style="font-size:12px; margin-right:10px; margin-left:10px"> <a href="/currents/0619-Molecular-delivery-system-takes-arthritis-drugs-directly-to-joints.cfm"><img alt="thumbnail" src="/images/research-currents/june19/Meka-Moudgil-sm.jpg" width="165" alt="Molecular delivery system takes arthritis drugs directly to joints">Molecular delivery system takes arthritis drugs directly to joints</a> </p> <p style="font-size:12px; margin-right:10px; margin-left:10px"> <a href="/currents/0418-muscling-in-on-muscle-loss.cfm"><img alt="thumbnail" src="/images/research-currents/apr18/sarcopenia-sm.jpg" width="165" alt="Muscling in on muscle loss: DC team seeks new ways to detect, treat sarcopenia">Muscling in on muscle loss: DC team seeks new ways to detect, treat sarcopenia</a> </p> <p style="font-size:12px; margin-right:10px; margin-left:10px"> <a href="/currents/0517-arthritis.cfm"><img alt="thumbnail" src="/images/research-currents/may17/arthritis-sm.jpg" width="165" alt="Knee popping? You may be at risk for arthritis">Knee popping? You may be at risk for arthritis</a> </p> </div>  <div class="rightcol_box"> <h4>VA Research in the News</h4> <ul><li><a href="http://medicalxpress.com/news/2013-06-cheaper-drugs-benefits-rheumatoid-arthritis.html" target="_blank" target="_blank" onclick="externalLink ()">Cheaper drugs produce same benefits for rheumatoid arthritis</a>, Medicalxpress, June 13, 2013</li> <li><a href="http://www.empr.com/in-veterans-with-ra-ptsd-worsens-disease-activity/article/280207/" target="_blank" target="_blank" onclick="externalLink ()">In Veterans with RA, PTSD worsens disease activity</a>, MPR, Feb. 13, 2013</li> <li><a href="http://news.wustl.edu/news/Pages/2953.aspx" target="_blank" target="_blank" onclick="externalLink ()">Arthritis drug may cause adverse side effects</a>, Washington University in St. Louis, Newsroom, Feb. 2013</li> <li><a href="http://www.usmedicine.com/rheumatoid-arthritis/most-common-causes-of-death-in-ra-patients/" target="_blank" onclick="externalLink ()">Most common causes of death in RA patients</a>, <i>U.S. Medicine,</i> Oct. 2015</li> <li><a href="http://www.rheumatologynews.com/index.php?id=8844&tx_ttnews%5Btt_news%5D=454281&cHash=f9bbd8293d96ffe04ea1fbeeab172133" target="_blank" onclick="externalLink ()">Adherence and persistence problems affect RA triple therapy more than TNFi combination therapy</a>, <i>Rheumatology News</i>, Nov. 18, 2015</li> <li><a href="http://www.hcplive.com/medical-news/patient-perceptions-around-surgery-pain-contribute-to-racial-disparity-in-total-knee-replacement" target="_blank" onclick="externalLink ()">Patient perceptions around surgery, pain contribute to racial disparity in total knee replacement,</a> <i>MD: All Specialties</i>, Dec. 18, 2015</li> </ul> </div> <div class="rightcol_box"> <h4>VA and other U.S. Government Online Resources</h4> <ul><li><a href="http://www.nia.nih.gov/health/publication/arthritis-advice" target="_blank" onclick="externalLink ()">Arthritis Advice</a>, National Institute on Aging, National Institutes of Health</li> <li><a href="http://www.healthfinder.gov/FindServices/SearchContext.aspx?topic=66" target="_blank" onclick="externalLink ()">Arthritis</a>, Healthfinder.gov, U.S. Department of Health and Human Services</li> <li><a href="http://nccam.nih.gov/health/arthritis" target="_blank" onclick="externalLink ()">Arthritis</a>, National Center for Complementary and Alternative Medicine, National Institutes of Health</li> <li><a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024677/" target="_blank" onclick="externalLink ()">Arthritis</a>, National Library of Medicine, National Institutes of Health</li> <li><a href="http://nihseniorhealth.gov/rheumatoidarthritis/whatisrheumatoidarthritis/01.html" target="_blank" onclick="externalLink ()">Rheumatoid Arthritis</a>, NIH Senior Health</li> <li><a href="http://www.niams.nih.gov/Health_Info/Bone/default.asp" target="_blank" onclick="externalLink ()">Bone Health and Osteoporosis</a>, National Institutes of Health, NIH Osteoporosis and related bone diseases national resource center</li> <li><a href="http://www.niams.nih.gov/?f=1" target="_blank" onclick="externalLink ()">National Institute of Arthritis and Musculoskeletal and Skin Diseases</a>, National Institutes of Health</li> <li><a href="http://www.womenshealth.gov/illnesses-disabilities/types-illnesses-disabilities/arthritis.html" target="_blank" onclick="externalLink ()">Arthritis</a>, Womenshealth.gov, U.S. Department of Health and Human Services</li></ul> </div>  <div class="clear"></div> </div>  <div class="clear"></div> </div>   <div class="clear"></div> </div>   <br style="clear: both" /> <br clear="all">  <div style="bottom:0; margin-left:30px; margin-top:30px; font-weight:bold; padding-top:10px; border-top:1px solid #cccccc;" id="footerBlock"> Questions about the R&D website? <a href="mailto:HSRDWeb.Boston@va.gov" style="color:#0B6CB2 !Important;">Email the Web Team</a> <span style="font-size:10px; font-weight:normal;"> <br> <br> Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.</span> </div> </div>   <div class="clear"> </div> </div> <div class="clear"> </div> </div> <div class="clear"></div> </div> </div> <div class="clear"></div>  <div id="footer-effect" style="height: auto;"> <div id="footer" class="noIndex"> <div class="col"> <h4>Veteran programs and services</h4> <ul > <li><a href="https://www.va.gov/homeless/" target="">Homeless Veterans</a></li> <li><a href="https://www.va.gov/womenvet/" target="">Women Veterans</a></li> <li><a href="https://www.va.gov/centerforminorityveterans/" target="">Minority Veterans</a></li> <li><a href="https://www.patientcare.va.gov/lgbt/" target="" rel="noopener noreferrer">LGBTQ+ Veterans</a></li> <li><a href="https://www.ptsd.va.gov" target="" rel="noopener noreferrer">PTSD</a></li> <li><a href="https://www.mentalhealth.va.gov" target="" rel="noopener noreferrer">Mental health</a></li> <li><a href="https://www.va.gov/adaptivesports/" target="">Adaptive sports and special events</a></li> <li><a href="https://www.va.gov/outreach-and-events/events/">VA outreach events</a></li> <li><a href="https://www.nrd.gov" target="_blank" rel="noopener noreferrer">National Resource Directory</a></li> </ul> </div>  <div class="col"> <h4 >More VA resources</h4> <ul> <li><a href="https://www.va.gov/find-forms/">VA forms</a></li> <li><a href="https://www.accesstocare.va.gov/" target="_blank" rel="noopener noreferrer">VA health care access and quality</a></li> <li><a href="https://www.va.gov/ogc/accreditation.asp">Accredited claims representatives</a></li> <li><a href="https://www.mobile.va.gov/appstore/" target="_blank" rel="noopener noreferrer">VA mobile apps</a></li> <li><a href="https://www.va.gov/statedva.htm">State Veterans Affairs offices</a></li> <li><a href="https://www.va.gov/landing2_business.htm">Doing business with VA</a></li> <li><a href="https://www.va.gov/jobs/">Careers at VA</a></li> <li><a href="https://www.va.gov/outreach-and-events/outreach-materials/">VA outreach materials</a></li> <li><a href="https://www.va.gov/welcome-kit/">Your VA welcome kit</a></li> </ul> </div>  <div class="col"> <h4>Get VA updates</h4> <ul> <li><a href="https://www.news.va.gov/" target="_blank" rel="noopener noreferrer">VA news</a></li> <li><a href="https://www.va.gov/opa/pressrel">Press releases</a></li> <li><a href="https://public.govdelivery.com/accounts/USVA/subscriber/new/" target="_blank" rel="noopener noreferrer">Email updates</a></li> <li><a href="https://www.facebook.com/VeteransAffairs" target="_blank" rel="noopener noreferrer">Facebook</a></li> <li><a href="https://www.instagram.com/deptvetaffairs/" target="_blank" rel="noopener noreferrer">Instagram</a></li> <li><a href="https://www.twitter.com/DeptVetAffairs/" target="_blank" rel="noopener noreferrer">Twitter</a></li> <li><a href="https://www.flickr.com/photos/VeteransAffairs/" target="_blank" rel="noopener noreferrer">Flickr</a></li> <li><a href="https://www.youtube.com/user/DeptVetAffairs" target="_blank" rel="noopener noreferrer">YouTube</a></li> <li><a href="https://www.va.gov/opa/socialmedia.asp">All VA social media</a></li> </ul> </div>  <div class="col"> <h4 style="font-size: 1.1rem; margin-bottom: 8px!important;">In crisis? Get help now</h4> <ul style="margin-bottom: 10px!important;"> <li><a href="https://www.veteranscrisisline.net/">Veterans Crisis Line</a></li> </ul> <h4 style="font-size: 1.1rem; margin-bottom: 8px!important;">Get answers</h4> <ul style="margin-bottom: 10px!important;"> <li><a href="https://www.va.gov/resources/">Resources and support</a></li> <li><a href="https://www.va.gov/contact-us/">Contact us</a></li> </ul> <h4 style="font-size: 1.1rem; margin-bottom: 8px!important;">Call us</h4> <ul style="margin-bottom: 10px!important;"> <li> <a href="tel:18006982411">800-698-2411</a></li> <li><a aria-label="TTY: 711" href="tel:+1711">TTY: 711</a></li> </ul> <h4 style="font-size: 1.1rem; margin-bottom: 8px!important;">Visit a medical center or regional office</h4> <ul style="margin-bottom: 10px!important;"> <li> <a href="https://www.va.gov/find-locations/">Find a VA location</a></li> </ul> </div>  <br clear="all"> <div style="margin: 20px;color: white;"> <hr color="#fff" style=" color:white; "> <br> <h4>Language assistance</h4> <a href="https://www.va.gov/asistencia-y-recursos-en-espanol" lang="es" hreflang="es"> Espanol</a>  |  <a href="https://www.va.gov/tagalog-wika-mapagkukunan-at-tulong" lang="tl" hreflang="tl"> Tagalog</a>  |  <a href="https://www.va.gov/resources/how-to-get-free-language-assistance-from-va/" lang="en" hreflang="en"> Other languages</a></div> <div style="margin: 20px;color: white;"> <hr color="#fff" style=" color:white; "> <br> <a href="https://www.section508.va.gov" rel="noopener noreferrer">Accessibility</a>  |  <a href="https://www.va.gov/resources/your-civil-rights-and-how-to-file-a-discrimination-complaint/">Civil Rights</a>  |  <a href="https://www.va.gov/foia/">Freedom of Information Act (FOIA)</a>  |  <a href="https://www.va.gov/oig/">Office of Inspector General</a>  |  <a href="https://www.va.gov/opa/Plain_Language.asp">Plain language</a>  |  <a href="https://www.va.gov/privacy-policy/">Privacy, policies, and legal information</a>  |  <a href="https://www.va.gov/privacy/">VA Privacy Service</a>  |  <a href="https://www.va.gov/ormdi/NOFEAR_Select.asp">No FEAR Act Data</a>  |  <a href="https://www.usa.gov/" target="_blank" rel="noopener noreferrer">USA.gov</a>  |  <a href="https://www.va.gov/performance-dashboard/">VA performance dashboard</a>  |  <a href="https://www.va.gov/veterans-portrait-project/">Veterans Portrait Project</a> </div> <div id="sub-footer"> <p>U.S. Department of Veterans Affairs  |  810 Vermont Avenue, NW Washington DC 20420</p> <p class="small-print"> Updated/Reviewed: 2021-1-15 </p> </div>  </div>  </div>    <script type="text/javascript"> //<![CDATA[ var usasearch_config = { siteHandle:"va_ord" }; var script = document.createElement("script"); script.type = "text/javascript"; script.src = "//search.usa.gov/javascripts/remote.loader.js"; document.getElementsByTagName("head")[0].appendChild(script); //]]> </script> </body></html>