ACR Advocates for Dedicated Department of Defense Arthritis Research Funding

Rheumatic disease disproportionately affects active members and veterans of the armed forces, and the U.S. Department of Defense (DOD) is explicitly charged with funding research on diseases that affect members of the military. For the past several years, the ACR and RheumPAC have teamed up with the Arthritis Foundation to advocate for dedicated arthritis research funding as part of the DOD’s Congressionally Directed Medical Research Program (CDMRP), which was created in 1992 to promote biomedical research that benefits both service members and the American public.

The ACR is working to secure $20 million dedicated to arthritis-focused medical research through the House defense appropriations process in the annual CDMRP budget. Among the points we make to lawmakers are:

• Rheumatoid arthritis is more prevalent among service members and veterans than in the general population. Approximately one in three veterans has arthritis, compared with one in four U.S. adults, according to the U.S. Centers for Disease Control & Prevention. And the incidence of osteoarthritis is more than twice as high in the military population over the age of 40 compared with the general population, showing a clear need for better prevention and treatment in this population.^1,2
• Osteoarthritis affects both the number and readiness of available service members. It is the leading cause of disability among U.S. veterans and the most common condition resulting from battle injury that leads to medical discharge from the military.^3,4 In addition, arthritis is the leading cause of disability among veterans, with 32% reporting doctor-diagnosed arthritis compared with 22% of non-veterans.⁵

One of the ACR’s volunteer leaders, Colin C. Edgerton, MD, FACP, RhMSUS, chair of the ACR Committee on Rheumatologic Care, has seen the toll that arthritis takes on men and women in the armed services. As rheumatology service chief at Eisenhower Army Medical Center, Fort Gordon, Ga., Dr. Edgerton was responsible for evaluating soldiers who were being medically discharged due to their arthritis symptoms, joint damage and disability. Now in private practice in North Charleston, S.C., Dr. Edgerton volunteers his time to educate lawmakers about how arthritis affects service members and veterans. He has made many trips to Washington, D.C., to talk with legislators and their staffs, offer presentations in Hill briefings and meet with Pentagon officials on this topic.

Currently, DOD funding for arthritis research may be obtained through broader programs, such as the Peer Review Medical Research Program, dependent on Senate delegation of the funds. Over the past 20 years, an average of $4.25 million per year has been awarded for arthritis-focused projects.⁶ These awards have yielded important advances, such as the development of new cartilage-penetrating nanocarriers for improved drug delivery to treat osteoarthritis.⁷ However, researchers across many disciplines must compete for the same funding, and the grants are difficult to secure. In addition, funding levels change each year based on budget appropriations, making such grants an unreliable source of arthritis research funding.

The ACR and RheumPAC, together with the Arthritis Foundation, are advocating for a dedicated line item in the CDMRP budget to allocate $20 million per year for arthritis research to better understand how to keep our service members healthy, allow them to conclude their careers on their own terms and live more comfortably in retirement. Visit the ACR’s Legislative Action Center to ask lawmakers to support funding for a dedicated DOD arthritis research program.

References

1. Cameron KL, Hsiao MS, Owens BD, et al. Incidence of physician-diagnosed osteoarthritis among active duty United States military service members. Arthritis Rheum. 2011 Oct;63(10):2974–2982.
2. Kopec JA, Rahman MM, Berthelot JM, et al. Descriptive epidemiology of osteoarthritis in British Columbia, Canada. J Rheumatol. 2007 Feb;34(2):386–393.
3. Cross JD, Ficke JR, Hsu JR, et al. Battlefield orthopaedic injuries cause the majority of long-term disabilities. J Am Acad Orthop Surg. 2011;19 Suppl 1:S1–S7.
4. Rivera JC, Wenke JC, Buckwalter JA, et al. Posttraumatic osteoarthritis caused by battlefield injuries: The primary source of disability in warriors. J Am Acad Orthop Surg. 2012;20 Suppl 1:S64–S69.
5. Dominick KL, Golightly YM, Jackson GL. Arthritis prevalence and symptoms among US non-veterans, veterans, and veterans receiving Department of Veterans Affairs Healthcare. J Rheumatol. 2006 Feb;33(2):348–354.
6. Department of Defense. Congressionally directed medical research programs.
7. Geiger BC, Wang S, Padera RF Jr., et al. Cartilage-penetrating nanocarriers improve delivery and efficacy of growth factor treatment of osteoarthritis. Sci Transl Med. 2018 Nov 28;10(469). pii: eaat8800.