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

Smolen, Josef S., Désirée M. F. M. Van Der Heijde, E William St Clair, Paul Emery, Joan M. Bathon, Edward Keystone, Ravinder N. Maini, et al. “Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial..” Arthritis and Rheumatism 54, no. 3 (March 2006): 702–10. https://doi.org/10.1002/art.21678.

PMID
16508926
Full Text

Renal Disease Subcommittee of the American College of Rheumatology  Ad Hoc Committee on Systemic Lupus Erythematosus Response Criteria, W. S. “The American College of Rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials..” Arthritis and Rheumatism 54, no. 2 (February 2006): 421–32. https://doi.org/10.1002/art.21625.

PMID
16453282
Full Text

Savage, C., and E. W. St. Clair. “Erratum to "New Therapeutics in Rheumatoid Arthritis" [Rheum Dis Clin N Am 32 (1) (2006) 57-74] (DOI:10.1016/j.rdc.2005.10.004).” Rheumatic Disease Clinics of North America 32, no. 2 (January 1, 2006). https://doi.org/10.1016/j.rdc.2006.05.009.

Full Text

St Clair, E William, and Thomas F. Tedder. “New prospects for autoimmune disease therapy: B cells on deathwatch..” Arthritis and Rheumatism 54, no. 1 (January 2006): 1–9. https://doi.org/10.1002/art.21525.

PMID
16385491
Full Text

Weinberg, J Brice, Thomas Lang, William E. Wilkinson, David S. Pisetsky, and E William St Clair. “Serum, urinary, and salivary nitric oxide in rheumatoid arthritis: complexities of interpreting nitric oxide measures..” Arthritis Research & Therapy 8, no. 5 (January 2006). https://doi.org/10.1186/ar2030.

PMID
16907988
Full Text

Wung, Peter K., Janet T. Holbrook, Gary S. Hoffman, Andrea K. Tibbs, Ulrich Specks, Y. -. I. Min, Peter A. Merkel, et al. “Herpes zoster in immunocompromised patients: incidence, timing, and risk factors..” The American Journal of Medicine 118, no. 12 (December 2005). https://doi.org/10.1016/j.amjmed.2005.06.012.

PMID
16378799
Full Text

Savage, C., E. W. St. Clair, and J. S. Sundy. “Emerging treatments for rheumatoid arthritis: Update.” Consultant 45, no. 9 (August 1, 2005): 984–95.

Scholars@Duke

Seo, Philip, Yuan-I Min, Janet T. Holbrook, Gary S. Hoffman, Peter A. Merkel, Robert Spiera, John C. Davis, et al. “Damage caused by Wegener's granulomatosis and its treatment: prospective data from the Wegener's Granulomatosis Etanercept Trial (WGET)..” Arthritis and Rheumatism 52, no. 7 (July 2005): 2168–78. https://doi.org/10.1002/art.21117.

PMID
15986348
Full Text

Haynes, Barton F., Judith Fleming, E William St Clair, Herman Katinger, Gabriela Stiegler, Renate Kunert, James Robinson, et al. “Cardiolipin polyspecific autoreactivity in two broadly neutralizing HIV-1 antibodies..” Science 308, no. 5730 (June 24, 2005): 1906–8. https://doi.org/10.1126/science.1111781.

PMID
15860590
Full Text

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