Frontiers in Inflammatory Joint Diseases Conference

ROBERT D. INMAN, MD, FRCPC,
The Arthritis Center of Excellence,
Toronto Western Hospital Research Institute,
and Departments of Medicine and Immunology,
University of Toronto, Toronto; and
HANI S. EL-GABALAWY, MD, FRCPC,
University of Manitoba,
Health Sciences Centre,
Winnipeg, Canada.

Address reprint requests to Dr. R.D. Inman, Arthritis Center of Excellence, ECW 8-005, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8. E-mail: robert.inman@uhn.on.ca

The Frontiers in Inflammatory Joint Diseases Confe rence was designed to bring together a wide spectrum of stakeholders to help define a vision for Canadian research in inflammatory joint diseases (IJD). The scope of these diseases includes rheumatoid arthritis, juvenile idiopathic arthritis, and the spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis, and reactive arthritis). Together, these disorders affect 2-3% of the general population, and they often begin during the most productive stages of an individual's life. In the case of childhood arthritis, the onset of arthritis can have a major influence on the growth and development of the child, both from the biologic and the social perspective. The impact of inflammatory joint diseases on society is staggering.

Fortunately, there has been considerable progress in the development of effective therapies for IJD, as well as progress in a better understanding of the pathogenesis of these disorders. The challenge at hand is to develop approaches to the early identification of these disorders, and to intervene with effective and cost-effective management strategies.

The stakeholders who gathered at the Frontiers Conference included consumer groups (patients), government representatives, research funding agencies, industry representatives, and clinicians and scientists with expertise in basic science, clinical trials, health services research, and population health.

The primary objectives of the conference were as follows:

1. To provide an opportunity for the CIHR's Institute of Musculoskeletal Health and Arthritis, the Canadian Arthritis Network, and The Arthritis Society to con-sult with consumers, policymakers, public agencies, and national and international researchers, as well as industry regarding priority national research themes that can lead to improved identification, understanding, and management, particularly of early arthritis;

2. To educate multiple stakeholders on the scope of current research in inflammatory joint diseases in Canada and globally;

3. To develop the Canadian research agenda in inflam-matory joint diseases;

4. To identify the unique qualities, opportunities, and resources that offer Canada a strategic niche in the global field of arthritis research.

Each day of the 3-day conference was organized with a distinct focus. Day one was designed principally for consumers - people from across Canada with different forms of inflammatory arthritis took part in an educational symposium entitled "Consumer Participation in Setting the Inflammatory Joint Diseases Research Agenda." The purpose was to provide a learning opportunity for consumers, policymakers, and other key stakeholders. There were 4 main parts to the agenda:

a. building Canadian arthritis research for the 21st

century;

b. current research trends in inflammatory arthritis;

c. ethical and legal issues;

d. best practices for informed patient advocacy.

The majority of participants were experienced consumer advocates; guest speakers were from Canada, the US, and the UK. One of the key elements of the conference was to balance presentations with ample time for roundtable discussions. As part of the roundtable discussion, consumers were asked to work on the question: "From your perspective, what key trends and related research issues offer significant potential for addressing health and health services issues associated with inflammatory joint diseases?" A summary of the responses was prepared and brought forward to the small-group planning work on day three.

Day 2 of the conference featured presentations and discussions on state-of-the-art research for various aspects of early arthritis. The roundtable discussions consisted of multidisciplinary small groups, designed to enhance the cross-fertilization between different areas of expertise. The principal areas of focus of small group discussions were:

1. Where we are: What is the cutting edge of our current knowledge? What are the major advances in Canadian and international research related to inflammatory joint diseases?

2. Where do we want to go: What are the existing strengths and resources and the emerging opportunities that position Canada to have global influence in arthritis research?

3. What must be addressed to get there: What elements offer significant potential for addressing key issues in the cause and cure of inflammatory joint disease? What obstacles need to be overcome to achieve these goals?

Day 3 focused on orientation to a strategic perspective presented by key speakers, as well as input from small groups on key questions and priorities.

The scientific program on Days 2 and 3 covered the following 4 areas:

a. biomedical perspectives

b. clinical interventions

c. challenges in clinician and population health studies

d. health services research.

The articles in this supplement reflect all these areas and are based on the presentations made by the conference speakers.