Eugene William St. Clair, MD

Professor of Medicine
W. Lester Brooks, Jr. Professor of Medicine
Chief, Division of Rheumatology and Immunology
Professor in Immunology
Campus mail 34229 Hosp South, Durham, NC 27710
Phone (919) 684-4499
Email address stcla003@mc.duke.edu

The main focus of my research is the pathogenesis and treatment of rheumatoid arthritis (RA). This work has been conducted using patient-oriented research methodologies in collaboration with basic scientists and other clinical investigators. A major area of interest has been the development of novel therapies for RA, which has primarily included studies of novel biologics. Another important area of investigation has been the possible role of nitric oxide in the pathogenesis of RA.

My research is conducted in our Clinical Trials Unit which is built around a staff of three clinical research coordinators and a collaborative relationship with Dr. William E. Wilkinson, a Ph.D. biostatistician. Our group has been involved in numerous clinical trials sponsored by the pharmaceutical industry. Another important project has been a study of doxycycline therapy in RA, which has been supported by the National Institutes of Health (NIH). Recently, we have
begun an epidemiologic study of SLE in collaboration with Glinda Cooper, an epidemiologist from the National Institutes of Environmental Health Services in the Research Triangle Park. The General Clinical Research Center, an NIH-supported facility, has frequently served as the site for our research.

The current biologic therapies under investigation in patients with RA include a peptide vaccine, IL-4, IL-10, and anti-tumor necrosis factor-à chimeric monoclonal antibody (anti-TNF). The peptide vaccine consists of a "shared HLA-DRB1 epitope", a short amino acid sequence common to the -chain of those HLA-DR molecules associated with RA. IL-4 and IL-10 are inhibitory cytokines that ameliorate arthritis in experimental animal models and are in the early stages of development as a possible treatment for human disease. The most promising of the novel biologics are those agents inhibiting TNF. Our center is now involved in a phase III clinical trial of anti-TNF in patients with RA, a study involving over 20 other sites in the United States and Europe. I am also principal investigator of an NIH-sponsored study investigating the treatment efficacy of doxycycline in RA and the ability of this antibiotic to suppress collagenase activity in vivo. The work involving nitric oxide has been supported by a Specialized Center for Research in RA (Barton F. Haynes, M. D., Principal Investigator). Other current studies include a clinical trial of DHEA in SLE, and the epidemiologic study of SLE, which is based in North and South Carolina and will examine the relationship between environmental exposures and the incidence of disease.

I have been a consultant for several pharmaceutical companies who are developing new therapies for RA. In addition, I have served as a consultant on NIH study sections for applications related to clinical trials of new anti-rheumatic therapies. I have also organized a Sjogren's Syndrome Clinic at Duke that attracts referrals from the southeastern part of the United States. I have also spoken at the Annual Scientific Meeting of the American College of
Rheumatology on subjects related to my research and clinical interests, including Sjogren's Syndrome, vasculitis, and autoantibodies. Finally, I am developing an investigator's network in the southeastern United States, which should provide the patient base and infrastructure to conduct large clinical trials in rheumatology.

Key words: rheumatoid arthritis, biologics, clinical trials, Sjogren's syndrome, systemic lupus erythematosus, nitric oxide

Education and Training

  • Chief Resident, Medicine, Duke University, 1984 - 1985
  • Fellow in Rheumatology, Medicine, Duke University, 1983 - 1985
  • Medical Resident, Medicine, Duke University, 1980 - 1983
  • M.D., West Virginia University, 1980

Publications

St Clair, EW. "In ANCA-associated vasculitis in remission, tailored vs fixed-schedule rituximab did not differ for relapse at 28 months." Annals of Internal Medicine 169, no. 6 (September 18, 2018): JC33-null.

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St Clair, EW, Baer, AN, Wei, C, Noaiseh, G, Parke, A, Coca, A, Utset, TO, Genovese, MC, Wallace, DJ, McNamara, J, Boyle, K, Keyes-Elstein, L, Browning, JL, Franchimont, N, Smith, K, Guthridge, JM, Sanz, I, James, JA, and Autoimmunity Centers of Excellence, . "Clinical Efficacy and Safety of Baminercept, a Lymphotoxin β Receptor Fusion Protein, in Primary Sjögren's Syndrome: Results From a Phase II Randomized, Double-Blind, Placebo-Controlled Trial." Arthritis & Rheumatology (Hoboken, N.J.) 70, no. 9 (September 2018): 1470-1480.

PMID
29604186
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Berti, A, Warner, R, Johnson, K, Cornec, D, Schroeder, D, Kabat, B, Langford, CA, Hoffman, GS, Fervenza, FC, Kallenberg, CGM, Seo, P, Spiera, R, St Clair, EW, Brunetta, P, Stone, JH, Merkel, PA, Specks, U, Monach, PA, and RAVE-ITN Research Group, . "Brief Report: Circulating Cytokine Profiles and Antineutrophil Cytoplasmic Antibody Specificity in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis." July 2018.

PMID
29693324
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Sullivan, KM, Majhail, NS, Bredeson, C, Carpenter, PA, Chatterjee, S, Crofford, LJ, Georges, GE, Nash, RA, Pasquini, MC, Sarantopoulos, S, Storek, J, Savani, B, and St Clair, EW. "Systemic Sclerosis as an Indication for Autologous Hematopoietic Cell Transplantation: Position Statement from the American Society for Blood and Marrow Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation (June 25, 2018).

PMID
29953945
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Rhee, RL, Davis, JC, Ding, L, Fervenza, FC, Hoffman, GS, Kallenberg, CGM, Langford, CA, McCune, WJ, Monach, PA, Seo, P, Spiera, R, St Clair, EW, Specks, U, Stone, JH, and Merkel, PA. "The utility of urinalysis in determining the risk of renal relapse in ANCA-associated vasculitis." Clinical Journal of the American Society of Nephrology 13, no. 2 (February 7, 2018): 251-257.

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Fudim, M, Thorpe, MP, Chang, LL, St Clair, EW, Hurwitz Koweek, LM, and Wang, A. "Cardiovascular Imaging With 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients With Fibroinflammatory Disorders." Jacc. Cardiovascular Imaging 11, no. 2 Pt 2 (February 2018): 365-368.

PMID
29413443
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Wallace, ZS, Miloslavsky, EM, Cascino, M, Unizony, SH, Lu, N, Hoffman, GS, Kallenberg, CGM, Langford, CA, Merkel, PA, Monach, PA, Seo, P, Spiera, R, St Clair, EW, Specks, U, Brunetta, P, Choi, HK, and Stone, JH. "Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis." Arthritis care & research 69, no. 7 (July 2017): 1004-1010.

PMID
27696762
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Merkel, PA, Xie, G, Monach, PA, Ji, X, Ciavatta, DJ, Byun, J, Pinder, BD, Zhao, A, Zhang, J, Tadesse, Y, Qian, D, Weirauch, M, Nair, R, Tsoi, A, Pagnoux, C, Carette, S, Chung, S, Cuthbertson, D, Davis, JC, Dellaripa, PF, Forbess, L, Gewurz-Singer, O, Hoffman, GS, Khalidi, N, Koening, C, Langford, CA, Mahr, AD, McAlear, C, Moreland, L, Seo, EP, Specks, U, Spiera, RF, Sreih, A, St Clair, EW, Stone, JH, Ytterberg, SR, Elder, JT, Qu, J, Ochi, T, Hirano, N, Edberg, JC, Falk, RJ, Amos, CI, Siminovitch, KA, and Vasculitis Clinical Research Consortium, . "Identification of Functional and Expression Polymorphisms Associated With Risk for Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis." Arthritis & Rheumatology (Hoboken, N.J.) 69, no. 5 (May 2017): 1054-1066.

PMID
28029757
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Clain, JM, Hummel, AM, Stone, JH, Fervenza, FC, Hoffman, GS, Kallenberg, CGM, Langford, CA, McCune, WJ, Merkel, PA, Monach, PA, Seo, P, Spiera, RF, St Clair, EW, Ytterberg, SR, Specks, U, and WGET and RAVE-ITN Research Groups, . "Immunoglobulin (Ig)M antibodies to proteinase 3 in granulomatosis with polyangiitis and microscopic polyangiitis." Clinical and experimental immunology 188, no. 1 (April 2017): 174-181.

PMID
28076879
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Cartin-Ceba, R, Indrakanti, D, Specks, U, Stone, JH, Hoffman, GS, Kallenberg, CGM, Langford, CA, Merkel, PA, Spiera, RF, Monach, PA, St Clair, EW, Seo, P, Tchao, NK, Ytterberg, SR, Brunetta, PG, Song, H, Birmingham, D, Rovin, BH, and RAVE-Immune Tolerance Network Research Group, . "The Pharmacogenomic Association of Fcγ Receptors and Cytochrome P450 Enzymes With Response to Rituximab or Cyclophosphamide Treatment in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis." Arthritis & rheumatology (Hoboken, N.J.) 69, no. 1 (January 2017): 169-175.

PMID
27482943
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