Doubling Down on the "Old People Get RA" Mythos

A little while ago I posted an article about how AmGen, the company behind the drug Enbrel, aired a commercial that furthered the stereotype that RA and autoimmune illness doesn’t affect children. I commented on how it was shameful that a company that definitely knows better would make a TV commercial that re-enforces one of the worst tropes out there about chronic illness and rheumatoid arthritis especially.

Misconceptions around autoimmune conditions

Well, I guess their focus groups and market research concluded that commercial was a hit because they’ve done it again! Yes, AmGen doubled down. Everyone’s favorite rheumatoid arthritis mascot, Phil Mickelson, is in a new TV commercial talking about when he was “young, long before he got psoriatic arthritis.”

While this is completely repellent and unbelievable to me, I think rather than an entire post scolding just one company (maybe a little scolding), we can use this time to talk about the misconceptions surrounding chronic inflammatory arthritis, especially the one about it not affecting children.

Children are diagnosed with autoimmune conditions

Now, I can trot out study after study and fact after fact that proves children are afflicted with many different forms of autoimmune arthritis, but the simple fact is I don’t have to. Why? Because, for me, this fact is as obvious as the hairpiece on your Middle School assistant principal.

Yup, just like that awful rug I was also left painfully exposed – at age nine, when I came down with rheumatoid arthritis, although it took two years to diagnose it. So, when asked if kids get autoimmune arthritis, I don’t have to Google the answer because I lived it. Yes, kids do, and even younger ones than me.

Juvenile idiopathic arthritis

This is made even more evident by the fact that the illness I was diagnosed with was, at the time, called “JRA.” No, the “J” doesn’t stand for Jersey, although I am extremely curious to see what that illness would look like – Jersey Rheumatoid Arthritis – like regular RA except you REALLY love Springsteen and you drive around on roads that go seemingly nowhere. No, in fact, that “J” stands for “juvenile.”

That’s right, there were so many children affected by the same illness that they gave it an entire category to itself. Although it’s now known as JIA (juvenile idiopathic arthritis), and it covers a much wider group of inflammatory arthritis conditions, the point remains valid – there are more than enough young people with the illness to stick a “juvenile” in front. This includes psoriatic arthritis!¹

Misinformation about children with JIA

Now, if you are most people, I think the above evidence would suffice. I mean, you don’t make an entirely separate category of disease if five people in the world have it. No, by simple common sense, there must be enough children afflicted with arthritis for it to be grouped all on its own.

Still, though, if that’s not enough proper evidence for you, here are some facts. It’s thought that almost 300,000 children in the US alone have some form of JIA.² That includes systemic JIA, oligoarthritis, polyarticular arthritis, psoriatic arthritis, enthesitis-related arthritis, and basically any other arthritis that doesn’t have a specific name. Those are the facts, people, and it’s why I get so upset when I see a company like AmGen spreading misinformation.

The issue of naming an illness after one symptom

I’m not naïve, I get why the stereotype exists. Frankly, I think that the marketing department failed miserably when they were asked to present their Powerpoint at the “JRA” naming convention. When you hear the word “arthritis,” you automatically picture an elderly woman in a chair rubbing her wrist, or an old retired baseball player with a bum shoulder, or a “trick knee” that acts up “when it gon’ blow up a storm somethin’ fierce!” Yeah, you know the scenes I’m talking about because you’ve seen them a thousand times.

The name is misleading

If I had been given the chance to speak at the JRA naming convention, I definitely would have pointed out that naming an illness after the one symptom that everyone associated with old people might not send the message we want! I mean, we could have called it Juvenile Rheumatoid Affliction, or Juvenile Rheumatoid Ailment, or heck, call it Juvenile Rheumatoid Apple Pie – I mean, it’s delicious and it has just about as much to do with old people arthritis as does JRA itself!

I always say JRA/JIA suffers from the curse of bad PR, and it’s true. “Arthritis” sends the wrong message. Shame on you, JRA committee – you should have spent less money on the wasabi salmon puffs and more on the marketing team.

How do people respond to RA misconceptions?

Fast forward to a few days ago, when I saw the new AmGen commercial for the first time and realized that the stereotype of only old people getting RA/IA was alive and well and actually must be profitable. I mean, for a company that literally manufactures drugs for kids with arthritis to push the misconception again, it must mean people are responding to it.

Dislike of RA stereotypes

Now look, I’m sure Mr. Mickelson is a wonderful person, but he's already kind of a pariah among the RA community. I can’t tell you how many RA conferences I’ve been to where I’ve heard the phrase, “Enough with Phil Mickelson!” To begin with, people were upset that he furthered the stereotype that those with inflammatory arthritis could pop onto the PGA pro tour with a quick injection – but that’s just not real life for the majority of RA/IA patients.

Most of us could barely pick up a golf stick (club?) and swing it without one of our shoulders literally disconnecting and flying around the room like a disembodied ghost arm trying to swat a fly. Well, not literally (idea for blog: ghost arm syndrome?). Now you factor in this added myth?

Well, let’s just say the future isn’t rosy for good ol’ Phil at RA conventions nor is the future for stamping out this particularly nasty stereotype. So do your part! And now I’m off for 18 holes. If come back with two arms, we’ll talk soon.