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

Parks, CG, Cooper, GS, Hudson, LL, Dooley, MA, Treadwell, EL, St Clair, EW, Gilkeson, GS, and Pandey, JP. "Association of Epstein-Barr virus with systemic lupus erythematosus: effect modification by race, age, and cytotoxic T lymphocyte-associated antigen 4 genotype." Arthritis Rheum 52, no. 4 (April 2005): 1148-1159.

PMID
15818712
Full Text

Merkel, PA, Lo, GH, Holbrook, JT, Tibbs, AK, Allen, NB, Davis, JC, Hoffman, GS, McCune, WJ, St Clair, EW, Specks, U, Spiera, R, Petri, M, Stone, JH, and Wegener's Granulomatosis Etanercept Trial Research Group, . "Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener's Clinical Occurrence of Thrombosis (WeCLOT) Study." Annals of Internal Medicine 142, no. 8 (April 2005): 620-626.

PMID
15838068
Full Text

Stone, JH, Rajapakse, VN, Hoffman, GS, Specks, U, Merkel, PA, Spiera, RF, Davis, JC, St Clair, EW, McCune, J, Ross, S, Hitt, BA, Veenstra, TD, Conrads, TP, Liotta, LA, Petricoin, EF, and Wegener's Granulomatosis Etanercept Trial Research Group, . "A serum proteomic approach to gauging the state of remission in Wegener's granulomatosis." Arthritis Rheum 52, no. 3 (March 2005): 902-910.

PMID
15751091
Full Text

Geletka, RC, and St Clair, EW. "Infliximab for the treatment of early rheumatoid arthritis." Expert Opin Biol Ther 5, no. 3 (March 2005): 405-417. (Review)

PMID
15833077
Full Text

Parks, CG, Pandey, JP, Dooley, MA, Treadwell, EL, St. Clair, EW, Gilkeson, GS, Feghali-Bostwick, CA, and Cooper, GS. "Erratum: Genetic polymorphisms in tumor necrosis factor (TNF)-α and TNF-β in a population-based study of systemic lupus erythematosus: Associations and interaction with interleukin-1α-889 C/T polymorphism (Human Immunology (2004) 65 (622))." Human Immunology 66, no. 3 (January 1, 2005): 331-null.

Full Text

St Clair, EW, van der Heijde, DMFM, Smolen, JS, Maini, RN, Bathon, JM, Emery, P, Keystone, E, Schiff, M, Kalden, JR, Wang, B, Dewoody, K, Weiss, R, Baker, D, and Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset Study Group, . "Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial." Arthritis and Rheumatism 50, no. 11 (November 2004): 3432-3443.

PMID
15529377
Full Text

Cooper, GS, Parks, CG, Treadwell, EL, St Clair, EW, Gilkeson, GS, and Dooley, MA. "Occupational risk factors for the development of systemic lupus erythematosus." J Rheumatol 31, no. 10 (October 2004): 1928-1933.

PMID
15468355
Scholars@Duke

Petri, MA, Mease, PJ, Merrill, JT, Lahita, RG, Iannini, MJ, Yocum, DE, Ginzler, EM, Katz, RS, Gluck, OS, Genovese, MC, Van Vollenhoven, R, Kalunian, KC, Manzi, S, Greenwald, MW, Buyon, JP, Olsen, NJ, Schiff, MH, Kavanaugh, AF, Caldwell, JR, Ramsey-Goldman, R, St Clair, EW, Goldman, AL, Egan, RM, Polisson, RP, Moder, KG, Rothfield, NF, Spencer, RT, Hobbs, K, Fessler, BJ, Calabrese, LH, Moreland, LW, Cohen, SB, Quarles, BJ, Strand, V, Gurwith, M, and Schwartz, KE. "Effects of prasterone on disease activity and symptoms in women with active systemic lupus erythematosus." Arthritis Rheum 50, no. 9 (September 2004): 2858-2868.

PMID
15452837
Full Text

Parks, CG, Pandey, JP, Dooley, MA, Treadwell, EL, St Clair, EW, Gilkeson, GS, Feghali-Bostwick, CA, and Cooper, GS. "Genetic polymorphisms in tumor necrosis factor (TNF)-alpha and TNF-beta in a population-based study of systemic lupus erythematosus: associations and interaction with the interleukin-1alpha-889 C/T polymorphism." Human Immunology 65, no. 6 (June 2004): 622-631.

PMID
15219382
Full Text

Maini, RN, Breedveld, FC, Kalden, JR, Smolen, JS, Furst, D, Weisman, MH, St Clair, EW, Keenan, GF, van der Heijde, D, Marsters, PA, Lipsky, PE, and Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group, . "Sustained improvement over two years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate." Arthritis Rheum 50, no. 4 (April 2004): 1051-1065.

PMID
15077287
Full Text

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