Grants for Research Into Arthritis and Depression
5th December 2006
Grants Awarded for Research Into Arthritis and Depression
The University of Otago’s Christchurch School of Medicine and Health Sciences has received an additional $2.3 million dollars for research into medication used in the treatment of rheumatoid arthritis, and the effectiveness of anti-depressants when used in primary health care.
The funding is awarded through the Health Research Council following reserve funds becoming available after the main grant round earlier this year. Grant applications go through a strict peer review process.
Dr Dee Mangin from the School’s Department of Public Health and General Practice is investigating the effectiveness of the anti-depressant fluoxetine (Prozac) in preventing recurrence of depression in primary health care.
Most (85-90%) depression is treated by GPs and depression in this setting is known to be different to that seen in hospitals. Many patients are now prescribed long-term maintenance therapy antidepressants to prevent recurrence of depression.
There is evidence for the effectiveness of this therapy with more severe depression treated in the hospitals, however this cannot necessarily be applied to patients in primary care. Recurrence of depression is lower in primary care (35% vs 75%), but there is no clear research evidence of the effectiveness of long-term antidepressants to prevent recurrence of depression in primary care.
The study will examine the comparative effectiveness of the continued treatment of 330 patients (who have been on antidepressants for at least a year) with fluoxetine, compared with a gradual withdrawal of the drug. It will examine the recurrence of depression, side effects, and general social and occupational functioning
“We know from research done in general practice that antidepressants are helpful in treating acute episodes of depression. This study will provide GPs and patients with information about the risks and benefits of longer term use to help them make treatment choices,” says Dr Mangin.
Rheumatoid arthritis is the focus of the second research grant. This is a chronic and painful condition affecting 1-2% of New Zealanders and causes joint inflammation, degradation of cartilage and erosion of bone. In the long run it can cause serious disability.
The investigation by Rheumatologist, Dr Lisa Stamp and colleagues, will examine whether the concentration of the anti-arthritis drug methotrexate in the blood determines how well a patient responds, and whether genetic make-up has anything to do with this response. At present it is not clear what the best levels of methotrexate are for different arthritis patients, to achieve optimal care without side-effects.
This study will also examine whether taking the commonly used drug methotrexate by subcutaneous injection is more efficacious than oral administration. The overall aim is to improve treatment with methotrexate through a blood test, making therapy more individualised for each patient, and improving long term outcomes.