Guest: Dr. Nathan Wei
Presenter: Neal Howard
Guest Bio: Dr. Nathan Wei (pronounced ‘way’) is a nationally known arthritis expert and former consultant to the National Institutes of Health. He is the author of more than 65 articles in peer reviewed literature and has appeared on NBC TV, CNBC, PBS, The Leading Experts Show, and has been featured in Arthritis Today, Women’s Day, The Washington Post, and Martha Stewart Living. He has international reputation for his expertise in regenerative medicine and innovative procedures.
Segment overview: Dr. Nathan Wei, MD, a board certified rheumatologist, discusses the newest advancement in treatments for arthritis.
Health Professional Radio – Treatments for Arthritis
Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you so much for joining us on the program today. Our guest in studio is Dr. Nathan Wei, Arthritis Expert and Consultant. He’s the Author of more than 65 articles and peer-reviewed literature and has appeared on NBC Television, CNBC, PBS and more and he’s here today with us on Health Professional Radio to discuss some of the latest advancements in arthritis treatment. Welcome to Health Professional Radio Dr. Wei.
Dr. Nathan Wei: Thank you very much Neal.
N: The things that we see on television, on the radios, some of these arthritis treatments, some of the creams, Australian dream and what-not. Are these not successful when it comes to treatment or are you talking about much better treatments than what we’ve been used to over the past 20-30 years?
W: Well I guess before I launched into the effectiveness of those types of treatments, let’s first define what arthritis is because it’s actually not one condition. It refers to a multiplicity of diseases of more than a hundred different types of arthritis and each is treated differently. That being said, the two most common that we see are osteoarthritis which is a wear and tear form of arthritis that affects cartilage that’s … between the ends of long bones and primarily weight bearing joints and that’s really the most common thing that we see in people after the age of about 30 or so. So when you see an older person hobbling around, in all likelihood they have osteoarthritis. The second most common type of arthritis is rheumatoid arthritis and this is a different type of arthritis, it’s not wear and tear, it’s autoimmune-based, in other words the body attacks itself. So in addition to all the joints which can be affected with inflammation, you also have a damaging effect on internal organs such as the lungs, the eyes, the heart and other areas. So two very different diseases treated very differently. So let’s get back to the Australian topical that we see and in fact on different medium we see all types of therapies that are touted to be effective.
N: Well you said there are more than a hundred types of arthritis, just arthritis, we talked about the rheumatoid and the osteo and how different they were both in character and in treatment. Are there any of these over a hundred that can be lumped into one type of treatment or are they actually each one treated differently as you said some of them have to be similar in character.
W: Well some are similar but still the treatment will vary a bit and with many diseases the treatment will vary a lot. So that’s why it’s so difficult to say “Okay we have this one treatment that’s gonna help you.” It’s sort of like the recent moonshot for cancer. Well we’re actually in the same stage with arthritis, it’s a moonshot to cure arthritis. But just as are many different kinds of cancer, there many different kinds for arthritis.
N: Okay so, back to the Australian topical.
W: Yeah, topical agents, over the counter topical agents can be helpful, how much of that is placebo effect though is difficult to know. Taking a treatment that you think is going to work is powerful particularly in a disease like arthritis where pain is something that is governed a lot by the brain.
N: Is it the different types of pain and symptoms that are generated that make a placebo effect more effective in one type or another or is it always up to the person rather than the particular type of disease?
W: It’s really a personal issue. The thing about placebo is that placebo works. We’re very active in clinical trials, researching new therapies for arthritis and it’s surprising to see how powerful that placebo effect is and that’s why our research studies are always double blinded, meaning the patient doesn’t know what they’re getting and I don’t know what they’re getting. And when we unblind the data, we can see placebo response as high as 60%.
N: Wow. When you’re talking about some of these topical agents being effective to a certain degree whether actual or the placebo effect. When do we start getting into invasive types of treatments and how can we avoid some of these invasive treatments using some of your therapies?
W: Well I think the key thing here is to try to avoid any type of surgical therapy particularly joint replacement if we can and we’ll talk a little bit later about some of the newer techniques there. But right now in our clinical trials we’re looking at cartilage growth agents, we’re looking at new methods for blocking pain, these are called nerve growth factor inhibitors, meaning that they’re able to block the actual sensation of pain so that obviously in a patient who has severe osteoarthritis of the hip or knee that’s really good because pain relief is what they’re looking for. At the same time though that does nothing to restore cartilage and really that sort of the Holy Grail as we see it now.
N: Are you taking old treatments that say include, say collagen or things of that nature and just improving on them or there’s totally new approaches that we had not thought of before or tried before?
W: These are new therapies. We’re entering a new phase of arthritis treatment, for example biologic therapy for rheumatoid arthritis and related types of conditions, the first biologic was approved in 1998 and has revolutionized our approach to taking care of patients with rheumatoid arthritis. At the same time though the much more common type of arthritis, osteoarthritis, we’re really not doing as good a job as we can and that’s why we’re looking for new therapies that hopefully will make new cartilage.
N: Talk about the Arthritis Treatment Center.
W: The Arthritis Treatment Canter actually was founded in 1981 and it began very small and what’s happened over the years is that we’re now conducting more than 25 clinical trials at one time and really what we’re aiming for as mentioned earlier is the moonshot for arthritis cure. When that’ll occur we don’t know but we’re constantly on the lookout for new therapies that will make a difference in the lives of our patients.
N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. We’ve been in studio with Dr. Nathan Wei, nationally known arthritis expert and Consultant, completed his Residency at the University of Michigan in Ann Arbor, Michigan and his arthritis training at the National Institute of Health in Bethesda, Maryland. He’s a former Consultant to the National Institute of Health and the Author of more than 65 articles and peer-reviewed literature and has appeared on NBC TV and here with us today on Health Professional Radio. It’s been a pleasure talking with you this afternoon Dr. Wei.
W: Thank you very much Neal. It’s been a pleasure as well.
N: Thank you. Transcripts and audio of this program are available at healthprofessionalradio.com.au and at hpr.fm and you can subscribe to this podcast on iTunes.