Arthritis UAE Emirates Dubai

Delay in diagnosis affects patients in UAE
http://archive.gulfnews.com/articles/08/10/31/10255829.html

10/30/2008 11:57 PM | By Nina Muslim, Staff Reporter



Dubai: Rheumatoid arthritis patients in the UAE are less likely to be diagnosed with the disease and receive treatment late by almost a year than their Western counterparts, according to a global study on the auto-immune condition.

The study, which was published in the medical journal Arthritis and Rheumatism last month, studied 5,848 patients in 24 countries, including the US and Finland. About 200 subjects, comprising expatriates and Emiratis participated in the study.

Dr Humeira Badsha, specialist rheumatologist with the Dubai Bone and Joint Centre and principal investigator for the UAE, told Gulf News the difference in diagnosis time between UAE patients and US patients were stark.

"The delay in diagnosis in the US is six months, but in the UAE, it is 13 months. It has improved [from the previous 18 months] but it is not enough," she said. "It's the same between Emiratis and expatriates, although Emiratis has a slightly [statistically insignificant] higher rate," she added.

She said the UAE was also significantly behind in access to rheumatoid arthritis medication, forcing the majority of patients to take less effective medicines. The study found 5 per cent of patients in the UAE have access to anti-TNF (Tumour Necrosis Factor) blockers.

"The ones who cannot afford the drugs get disabled faster," she added.

She blamed lack of insurance regulations for the lack of access, saying some insurance companies have refused to pay for the expensive treatment, citing pre-existing condition and other clauses. Rheumatoid arthritis is an auto-immune disease in which the joints become less mobile. Left untreated, it can lead to disability and death.

Rheumatologists aim to achieve remission, usually by using anti-TNF blockers.

Rheumatoid Arthritis in the UAE

28 October 2008
Study also shows many UAE patients unable to afford the right treatment
Dubai, UAE In a recent study published in a leading American journal, Arthritis and Rheumatism, researchers have identified many gaps in care of Rheumatoid Arthritis (RA) patients in the UAE as compared with Western countries.

In the UAE, only 18% of patients could achieve the goal of 'disease remission' as compared to 36-40% in Western countries including the USA, Netherlands and Finland.

Remission is defined as the absence of clinical signs of inflammation such as red, swollen joints which are warm to the touch; joint pain and stiffness; and loss of joint function.

According to Dr. Scott J. Zashin, author of Arthritis Without Pain-The Miracle Of Anti-TNF Blockers, a very small percentage of patients may be able discontinue their arthritis medications, while over 95% need to continue their medications to remain in remission.

Dr. Zashin explains: "While there is no way to determine who will achieve remission with therapy, patients taking combination therapy are more likely to achieve remission than those taking either drug alone. The longer the disease remains in remission, the less likely it is to become active again."

Patients in the UAE also had more severe disease as compared to other countries, based on disease activity scores.

The study was conducted in collaboration with Finland and USA and covered 5,848 patients in 67 sites over 24 countries, including the UAE as the only Arab country.

The principal investigator for the UAE, Dr. Humeira Badsha, Specialist Rheumatologist at the Dubai Bone and Joint Center, explained that these figures are prevalent because of two- main reasons.

Firstly, patients have a delay in diagnosis of 18 months and a further delay of treatment of 12 months. This is because patients do not think that there is an effective treatment available and there is a general lack of information about the disease.

Secondly, the best chance for 'disease remission' is use of a combination of medications including a new type called biological drugs. Unfortunately, these medications are very expensive and most patients cannot afford them.

"Insurance companies cover this treatment in only 50% of cases. In the USA, 40% of patients with rheumatoid arthritis are receiving these drugs but our data reveals that only 5% of UAE patients are getting them," Dr. Badsha adds.

Dr. Badsha has been the principal investigator in various clinical trials of medications for RA in the UAE. She has further conducted various research studies on Lupus and Autoimmune diseases and published several papers in leading journals.

- Ends -

About Dubai Bone and Joint Center
Dubai Bone and Joint Center (DBAJ) is the first and only center for musculoskeletal treatment and research in the Middle East, offering patients world-class specialists and facilities to improve their quality of life and to have a chance to live a pain free life.

DBAJ aims to operate according to international healthcare standards by offering residents and expatriates in the Middle East the highest quality and the latest innovative treatments and evidence-based medicines according to international protocols.

The center addresses various conditions ranging from children and adult spinal conditions, pelvic and acetabular fractures, reconstructive surgery, and rheumatology. It also offers total joint arthroplasty, revision total joint arthroplasty, limb lengthening and limb deformity correction, infective non-union surgery, foot deformities, neuromuscular disorders, and sports medicine.

DBAJ is a committed associate of the government's efforts to develop Dubai into a 'Center of Medical Excellence' for the region. It is a member of Dubai Healthcare City.

The Emirates Canada Arthritis Partnership

Dr. Cathy leibman of the Emirates Arthritis Foundation and myself, Dr. Humeira Badsha also from the Foundation and Dubai Bone and Joint center just returned from Toronto where we were invited to attend the Canadian Arthritis Network's annual meetin as their International Partners. We are especially proud of this initiative as it gives us access to some of the best research minds in the world and many new projects on arthritis will be born. We were also extremely impressed by the well ionformed and amazing consumer advocates who are such a powerful voice against these groups of diseases. We learned a lot and hope to continue to do so.

Special thanks to Dr. Claire Bombardier and John Riley from CAN, Dr. badley and Dr. Mary Bell who tool the time to sit down with us...

Osteoporosis United Arab Emirates UAE

XPress Dubai
Published: October 14, 2008, 16:28
Health watch: Say 'yes' to sunshine
By Kamakshi Gupta, Staff Reporter
Women in the UAE are prone to osteoporosis, experts said. "Approximately 80 per cent of post-menopausal women suffer from Vitamin D deficiency and this number is on the rise," said Dr Humeira Badsha, Specialist Rheumatologist, Dubai Bone and Joint Centre. “This is an alarming figure, and one of the reasons is lack of awareness. In fact, the problem has reached epidemic proportions in the UAE,” added Dr Salman Hameed, Orthopaedic Surgeon, Prime Medical Centre, ahead of the World Osteoporosis Day on October 20. He said the number of expatriates with low bone density is also significant, and that genetically Arabs and Asians are exposed to a higher risk of osteoporosis, a condition of reduced bone density that may lead to fractures. Factors like poor calcium intake and lack of vitamin D can also lead to the condition, he added. “When there is insufficient calcium in the blood, the body is forced to release calcium from the bones. This depletes the bone density and makes it weak.” Dr Hameed said weak bones can lead to fractures -- mainly of hips, spine and wrist. Fractures cause hospitalisation, immobility and in some cases, mortality. “People are unaware that Vitamin D is needed for the calcium to be absorbed in the body. Vitamin D is present in our skin and gets activated when the skin is exposed to the sun’s ultraviolet rays.” In a country with plenty of sunshine, high prevalence of osteoporosis due to lack of exposure to sunlight is ironical. Dr Hameed said exposure to sunlight - an optimum source of vitamin D - and sufficient calcium intake - either through foods rich in calcium or supplements - can reduce the number of osteoporotic patients in the country. “Diet plays an important role.” Excessive alcohol, smoking and poor lifestyle habits can lead to loss of bone mass in the long run, he said. “Excessive consumption of carbonated drinks can dissolve the calcium in the bones.”
Dr Hameed said people above 50 should get their bone density checked. “If the problem is detected early, we can prevent fractures and complications of osteoporosis. Early intervention is the key.” Fast tips

Osteoarthritis knee treatment

The prognosis for people with knee osteoarthritis isn't so bleak as it might seem in the wake of a study finding that arthroscopic surgery, once hailed as promising, might not be the best option. The study, published in the Sept. 11 issue of the New England Journal of Medicine, "suggested that people who underwent the surgery didn't fare any better in the long run than their counterparts who received physical therapy. The trick is to find one or more treatments -- amid the array that includes medication and physical therapy -- that can ease the pain of worn cartilage. For instance, one knee surgeon gives patients "a list of 17 options to help them manage their condition. At the very bottom is arthroscopy." Some experts say "oral nonsteroidal anti-inflammatories, such as Celebrex (celecoxib), can reduce inflammation and pain, as can cortisone injections." Others recommend acupuncture and massage. Still, others advise patients to exercise -- walking, swimming, and water workouts -- because physical activity can produce "some long-lasting effects."

World Arthritis Day 2008 Emirates (UAE)

The Emirates Arthritis Foundation have received the results from the WorldArthritis Day Survey which 50 countries participated in and it was conductedin 9 languages including Arabic. This is the first year that the UAE hasbeen represented and it is beneficial that we now have data just for theUAE.I have attached the results and the press release that will go out aroundWorld Arthritis Day.Of considerable note is that1. 40% of patients in the UAE would feel more positive in their lifewith arthritis if they had better access to a medical team2. 70% of patients in the UAE stated that their arthritis affects thememotionally with 17% leading to depression yet only 25% of them raise thisissue with their doctorThe Foundation will hold workshops in 2009 for those suffering witharthritis/rheumatism to address the emotional challenges of our arthritispatients. Our mission at EAF is to improve the quality of life for arthritissufferers here in the Middle East and we plan to take a proactive role inthis.

Helping Arthritis patients in Dubai