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

Breedveld, FC, Emery, P, Keystone, E, Patel, K, Furst, DE, Kalden, JR, St Clair, EW, Weisman, M, Smolen, J, Lipsky, PE, and Maini, RN. "Infliximab in active early rheumatoid arthritis." Ann Rheum Dis 63, no. 2 (February 2004): 149-155.

PMID
14722203
Scholars@Duke

Cooper, GS, Treadwell, EL, Dooley, MA, St Clair, EW, Gilkeson, GS, and Taylor, JA. "N-acetyl transferase genotypes in relation to risk of developing systemic lupus erythematosus." J Rheumatol 31, no. 1 (January 2004): 76-80.

PMID
14705222
Scholars@Duke

Parks, CG, Cooper, GS, Dooley, MA, Treadwell, EL, St Clair, EW, Gilkeson, GS, and Pandey, JP. "Systemic lupus erythematosus and genetic variation in the interleukin 1 gene cluster: a population based study in the southeastern United States." Ann Rheum Dis 63, no. 1 (January 2004): 91-94.

PMID
14672899
Scholars@Duke

Lamprecht, P, and Gross, WL. "A brief history of Wegener's granulomatosis: on limited, localized, and generalized forms of the disease: comment on the article by the Wegener's Granulomatosis Etanercept Trial Research Group." Arthritis and rheumatism 50, no. 1 (January 2004): 334-335. (Letter)

PMID
14730635
Full Text

Parks, CG, Hudson, LL, Cooper, GS, Dooley, MA, Treadwell, EL, St Clair, EW, Gilkeson, GS, and Pandey, JP. "CTLA-4 gene polymorphisms and systemic lupus erythematosus in a population-based study of whites and African-Americans in the southeastern United States." Lupus 13, no. 10 (2004): 784-791.

PMID
15540511
Full Text

Liang, MH, Fortin, P, Schneider, M, Abrahamowicz, M, Alarcón, GS, Balow, J, Benito-Garcia, E, Bischoff-Ferrari, H, Bombardieri, S, Buyon, J, Chehab, G, Crofford, L, Pablo, PD, Esdaile, JM, Fischer-Betz, R, Gladman, D, Illei, G, Johnson, K, Kalden, J, Khamashta, M, Koike, T, Lockshin, M, Manzi, S, McCune, J, Meyrier, A, Mikdashi, J, Moore, A, Mosca, M, Petri, M, Phillips, C, Jr, NR, Schur, P, Smolen, J, Clair, EWS, and Strand, V. "Criteria for steroid-sparing ability of interventions in systemic lupus erythematosus: Report of a consensus meeting." Arthritis and Rheumatism 50, no. 11 (2004): 3427-3431.

PMID
15529380
Full Text

Liang, MH, Fortin, P, Schneider, M, Abrahamowicz, M, Alarcón, GS, Bombardieri, S, Balow, J, Benito-Garcia, E, Bischoff-Ferrari, H, Buyon, J, Chehab, G, Costenbader, K, Crofford, L, Pablo, PD, Esdaile, JM, Finckh, A, Fischer-Betz, R, Gladman, D, Gordon, C, Illei, G, Isenberg, D, Iking-Konert, C, Johnson, K, Kalden, J, Khamashta, M, Koike, T, Lockshin, M, Manzi, S, McCune, J, Meyrier, A, Mikdashi, J, Moore, A, Mosca, M, Petri, M, Phillips, C, Jr, NR, Schur, P, Smolen, J, Clair, EWS, and Strand, V. "The American College of Rheumatology response criteria for systemic lupus erythematosus clinical trials: Measures of overall disease activity." Arthritis and Rheumatism 50, no. 11 (2004): 3418-3426.

PMID
15529383
Full Text

Geletka, R, and St Clair, EW. "Treatment of early rheumatoid arthritis." Best Pract Res Clin Rheumatol 17, no. 5 (October 2003): 791-809. (Review)

PMID
12915158
Scholars@Duke

Criscione, LG, Sugarman, J, Sanders, L, Pisetsky, DS, and St Clair, EW. "Informed consent in a clinical trial of a novel treatment for rheumatoid arthritis." Arthritis Rheum 49, no. 3 (June 15, 2003): 361-367.

PMID
12794792
Full Text

Fraser, PA, Ding, W-Z, Mohseni, M, Treadwell, EL, Dooley, MA, St Clair, EW, Gilkeson, GS, and Cooper, GS. "Glutathione S-transferase M null homozygosity and risk of systemic lupus erythematosus associated with sun exposure: a possible gene-environment interaction for autoimmunity." J Rheumatol 30, no. 2 (February 2003): 276-282.

PMID
12563680
Scholars@Duke

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