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

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


Hamilton, K., and E. W. Clair. “Tumour necrosis factor-alpha blockade: a new era for effective management of rheumatoid arthritis..” Expert Opin Pharmacother 1, no. 5 (July 2000): 1041–52.

Full Text

Levesque, M. C., D. A. Mackin, J. A. Fleming, and E. W. St Clair. “Serum levels of soluble CD44 in primary Sjögren's syndrome..” J Rheumatol 27, no. 6 (June 2000): 1444–49.


Kavanaugh, A., E. W. St Clair, W. J. McCune, T. Braakman, and P. Lipsky. “Chimeric anti-tumor necrosis factor-alpha monoclonal antibody treatment of patients with rheumatoid arthritis receiving methotrexate therapy..” J Rheumatol 27, no. 4 (April 2000): 841–50.


St Clair, E. W. “Interleukin-10: therapeutic prospects in rheumatoid arthritis..” Curr Dir Autoimmun 2 (2000): 126–49.


St Clair, E. W. “Interleukin 10 treatment for rheumatoid arthritis.” Annals of the Rheumatic Diseases 58, no. SUPPL. 1 (December 16, 1999).


Maini, R., E. W. St Clair, F. Breedveld, D. Furst, J. Kalden, M. Weisman, J. Smolen, et al. “Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group..” Lancet 354, no. 9194 (December 4, 1999): 1932–39.


St  Clair EW, H. “Therapy of rheumatoid arthritis: new developments and trends..” Curr Rheumatol Rep 1, no. 2 (December 1999): 149–56.


Verma, A., E. W. St Clair, and R. A. Radtke. “A case of sustained massive gabapentin overdose without serious side effects..” Ther Drug Monit 21, no. 6 (December 1999): 615–17.


Williams, H. J., G. S. Alarcon, R. Joks, V. D. Steen, K. Bulpitt, D. O. Clegg, C. M. Ziminski, et al. “Early undifferentiated connective tissue disease (CTD). VI. An inception cohort after 10 years: disease remissions and changes in diagnoses in well established and undifferentiated CTD..” J Rheumatol 26, no. 4 (April 1999): 816–25.