Tag Archives: NIAMS

At 25 Years, NIAMS Celebrates Progress, But Has a Long Way to Go

It’s been 25 years since the establishment of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and great strides have been made in diagnosis, treatment, and management of numerous conditions, “but you ain’t seen nothing yet,” said Dr. Francis Collins, director of the National Institutes of Health.

Opportunities for medical research have never been as great as they are today, said Dr. Collins, who gave the welcome address for NIAMS’ 25th anniversary at the NIH campus in Bethesda, Md.

Although prominent researchers in the field agreed that research has come a long way in the past 25 years, they stressed that there is still a long way to go. Currently, the molecular basis for 4,000 diseases is known, said Dr. Collins. “But we have effective treatment for only 200.”

In broad strokes, the day-long event touched on the past, present, and future of major diseases of bones, joints, muscles, and skin – including muscular dystrophies, osteoporosis, rheumatoid arthritis, and lupus – through panels and discussion involving prominent researchers, physicians, and patient advocates.

“These diseases are chronic, crippling, and common,” said Dr. Stephen Katz, director of NIAMS, in his opening address. “They affect every family in the United States.”

Among the attendees were many researchers and clinicians who said they felt loyalty and appreciation for receiving funding from NIAMS at some point in their career. For some, the progress in the past 2 decades was quite tangible.

“Public investment in osteoporosis research has really changed how we take care of the patients,” said Dr. Sundeep Khosla, president of the American Society for Bone and Mineral Research. Dr. Khosla, professor at the Mayo Medical School, Rochester, Minn., recalled a time more than 2 decades ago when calcium, vitamin D, and estrogen were the only options he could offer to patients with osteoporosis.

A few years later, bisphosphonates became available, then came anabolic drugs, and now more drugs are in the pipeline. Patient diagnosis also has advanced, he said. Although he agreed that the field still has a long way to go, he was optimistic about more progress. “Who knows what will happen in the next 25 years?” he asked.

There was talk of individualized therapy, balancing research and treatment, and a closer collaboration among scientists, all in the spirit of bringing better diagnosis and treatment to patients.

“We’re in a different world from when all we had was aspirin,” said Dr. Daniel Kastner, a scientific director at the National Human Genome Research Institute. “But what we really want is a cure. And we’re not there yet.”

Naseem S. Miller (@ReportingBack)

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Filed under Allergy and Immunology, Dermatology, Family Medicine, Genomic medicine, IMNG, Internal Medicine, Primary care, Rheumatology, Video

An Itch to Treat Itching More Effectively

Never underestimate the power and the agony of itching, or our inability to stop it.

Image by flickr user janhatesmarcia (Creative Commons)

I learned that many years ago at the impressionable age of 18, as I shared a hospital room with an elderly patient who suffered chronic, severe vaginal itching. If the thought of that doesn’t make you wince, this might – I could hear the attending and resident physicians standing just outside the door of our room talk about her as if we, the patients, weren’t there. They didn’t have a clue how to help her. So they decided the problem must be all in her head. One said in an irritated voice, “Let her go home and itch.”

That was 1974. Oh, how times have changed. Today, physicians and researchers are recognizing that chronic itch is like chronic pain – once it is present, it can permanently change the central nervous system to make treatment much more difficult, Dr. Timothy Berger explained at Skin Disease Education Foundation‘s Las Vegas Dermatology Seminar. We might begin to see treatments that act not just peripherally but centrally.

Photo by flickr user fifikins (Creative Commons)

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) on Oct. 29, 2010, held its first roundtable discussion on pruritus (itching), said Dr. Berger, of the University of California, San Francisco. A summary of the meeting and a list of attendees will be posted on the NIAMS Web site before the end of 2010, NIAMS media liaison Trish Reynolds told me.

Pruritus experts have expressed interest in following the example set by some European centers to create major referral centers for itch, much like pain referral centers, Dr. Berger said. Patients with difficult itching would be referred to these centers, which would collect and analyze data, store tissue samples, and tackle pruritus in a much more organized and – one hopes – successful way.

“We’re now at the point where we might be able to do something about itch,” he said.

Now, that’s what I call relief.

–Sherry Boschert

Disclosure: Skin Disease Education Foundation and my employer, International Medical News Group, are both owned by Elsevier.

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Filed under Allergy and Immunology, Anesthesia and Analgesia, Dermatology, Family Medicine, IMNG, Internal Medicine, The Mole, Uncategorized