Deborah Norville honors her mom's memory by helping find a cure for rheumatoid arthritis.

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

Inside Edition anchor and veteran journalist Deborah Norville has a good ear for a story.  But Norville also has a good heart when it comes to raising awareness about rheumatoid arthritis (RA).

"I lost my mother to rheumatoid arthritis when I was 20," says the Emmy-winning anchor and former co-host of the NBC's Today Show. "She got to see me on TV twice. But she never met my husband or my children."

To honor her mother's memory, Norville has been a long-time supporter of the Arthritis Foundation. Last year Norville was awarded Person of the Year by the Chicago Arthritis Foundation for her support in launching their telethon.

Norville says that her mother's diagnosis with RA launched a new era in her family's life.

"Within a few months of her diagnosis there were demonstrable changes in her ability to hold things, go places, all of which were followed by even more pain in her joints," Norville recalls. "I mark the timeline of my childhood as 'mom was walking then,' 'mom had the walking cane then,' 'mom had the walker,' 'mom was in the wheel chair,' and finally 'mom was bedridden then.'"

With each additional piece of medical equipment, Norville says it signified another reduction in her mother's ability to carry on the simplest tasks of daily living.

"She used to call us her arms and legs," Norville says. "Every Christmas we would ask her what she wanted for Christmas and she would always say, 'A new set of legs,'" She never wanted anything else but a new set of legs."

And her mother's lifelong dream on one day taking her four daughters shopping in Paris was never realized when complications from RA claimed her life in 1978.

Inside RA

Norville's experience with her mother's battle with RA has never left her.  She continues to be a passionate advocate and fundraiser for a disease that affects an estimate 2.1 million Americans.  Recently, Norville teamed up with pharmaceutical giants Amgen and Wyeth, makers of a RA treatment, to increase awareness about RA.

"What I want people to know is that for those who are dealing with rheumatoid arthritis it is a very frustrating and often depressing for them to deal with their disease," Norville says. "Often times it is not easily diagnosed. Usually the diagnosis of RA comes after they have eliminated everything else so just getting a correct diagnosis can be a very challenging situation."

RA is one of the most serious forms of arthritis and is a chronic lifetime disease that over time has the potential to damage and/or deform joints, produce major disability and even cause death. RA results from the immune system inappropriately attacking tissues inside the joint capsule, causing damaging inflammation.

While anyone, including children, can be afflicted with RA, those most at risk are women usually between the ages of 20 and 40 and people with a family history of RA.

"Rheumatoid arthritis is primarily a disease of the joints and almost all joints can be affected - but the hands, wrists and feet are particularly targeted," says John Klippel, rheumatologist and medical director of the Arthritis Foundation. "It begins with pain, swelling, tenderness and joint stiffness that persists well into the morning and even into the afternoon."

According to Klippel, the swelling in the hands or feet is often characterized by heat, redness or tenderness and occurs on a daily basis. Fatigue and weight loss are also common in RA. And about one in five patients develop bumps under the skin called nodules, often classically located near the elbow.

"There are many causes of arthritis and the symptoms of RA can be mimicked by other diseases so people need to understand that if they develop some of these symptoms, they should see a rheumatologist and get a proper diagnosis," says Klippel. "It is important to start therapy early because we want to intervene in this disease before there is joint damage."

Hopeful options

Norville's mother did not have the treatment options available to many RA patients today.

"Mostly, she had steroids," Norville reports. "Today however there is a whole new crop of drugs that have proved to be not only effective in relieving the pain but also stopping the progression of RA."

"The use of NSAIDs and corticosteroids are important to reduce inflammation," Klippel explains. "But the real excitement in the field is that a number of these newer drugs or biologic therapies can not only reduce inflammation but also can help to limit and, in many patients, prevent joint damage."

The standard therapy for the last decade has been methotrexate. Originally developed to treat cancer, it is highly effective and can prevent joint damage. Another effective treatment is a disease modifying drug called leflunonide.  Both are taken orally.

"But there are now four FDA-approved biologic agents," Klippel says. "While the former two drugs are administered orally, these drugs are taken intravenously. They have to be injected.  Three of the four -- Enbrel, Remicade and Humira -- target a cytokine called tumor necrosis factor." Cytokines seems to play a major role in the inflammatory response of RA.

The fourth biologic is called Kineret that is directed against IL1 - or interleukin 1 - which is also linked to the inflammation process.

"Today there are people with RA who were once suffering like my mom but who have found medications that bring relief and help stop the progression of the damage," Norville says. "It's too late for my mom, but there are others out there who can benefit from this awareness."

Norville and Klippel both stress that these medications are not a cure. But each can potentially improve a patient's quality of life. 

"And not every drug will work for every patient," Norville urges. "I'm not out here to sell anything.  I want people to simply ask questions. The message of this campaign is to underscore that people who have perhaps given up hope can look into some of the new drugs available. Don't give up hope.  Keep asking questions. Chances are there is an answer out there that can help you or someone you love."

• The Arthritis Foundation

• The Hope Relay

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 7/27/2003  -  Donnica Moore, M.D.