Michaud credits Arthritis Foundation funding for making this project the first of its kind in RA possible. He plans to continue studying the impact of joint replacement in RA. In the meantime, Michaud started a new database called the Arthritis Internet Registry (AIR), a web-based study and social networking opportunity for people with RA and other rheumatic diseases.

“The award from the Arthritis Foundation was crucial in helping me with this study and provided me with the flexibility and time to work on other projects including AIR, which wouldn’t have happened otherwise,” says Michaud.

Walking on “AIR”

AIR was put into motion in 2010. Patients sign up via the Arthritis Foundation website and also provide an optional one-time blood sample. Michaud and Robert Plenge, MD, a geneticist and rheumatologist at Harvard University, got the database up and running and oversee its progress.  Michaud credits early, crucial support from John Hardin, MD, vice president of research for the Arthritis Foundation, and E. William St. Clair, MD, president of the American College of Rheumatology’s Research and Education Foundation.

The Arthritis Foundation provides support and advertising through their website. The NDB provided the infrastructure of their website, staff and database for questionnaires; Quest Diagnostics offers free blood draw at their clinics.

Members of AIR answer two questionnaires a year. In turn, the researchers send reports back to patients and follow their progress over time. For example, researchers can compare how certain medications are helping, or whether individual patients do better in winter or summer. Michaud is also working on creating online communities so patients can stay in touch with one another.

Blood samples allow researchers to link blood and genetic markers to each patient, and, in the future, to select family members. These details will help researchers see whether blood profiles and medical experience can shed light on genetic and environmental factors as RA takes its course, help predict disease severity, and even prevent it from ever happening.

“As we do with the NDB, we learn the most from patients themselves. How they’re doing right now is helpful but how they’re doing over the next 10, 15 or 20 years will be so much more helpful. The more we can learn from their experience with their disease, the better,” says Michaud.

AIR researchers aim to make the site interactive and beneficial. Future plans include a medication diary so patients can log when they switch to a new drug. Michaud also wants to include smart phones to track when people experience flares, because such information is usually not recorded.

Frederick Wolfe, MD, a rheumatologist and researcher in Kansas who started the NDB in 1998, has already used data from some of the patients enrolled through the AIR database in his studies of RA and other forms of arthritis.

“This is a very exciting project and it offers an opportunity for patients to participate and for all of us who are studying the outcomes of these illnesses in the broadest sense of the word to benefit from their enrollment,” says Dr. Wolfe.