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

Williams, HJ, Alarcon, GS, Joks, R, Steen, VD, Bulpitt, K, Clegg, DO, Ziminski, CM, Luggen, ME, St Clair, EW, Willkens, RF, Yarboro, C, Morgan, JG, Egger, MJ, and Ward, JR. "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): 816-825.

PMID
10229402
Scholars@Duke

Moreland, LW, and St Clair, EW. "The use of analgesics in the management of pain in rheumatic diseases." Rheum Dis Clin North Am 25, no. 1 (February 1999): 153-vii. (Review)

PMID
10083963
Scholars@Duke

St Clair, EW, and McCallum, RM. "Cogan's syndrome." Curr Opin Rheumatol 11, no. 1 (January 1999): 47-52. (Review)

PMID
9894630
Scholars@Duke

Perkins, DJ, St Clair, EW, Misukonis, MA, and Weinberg, JB. "Reduction of NOS2 overexpression in rheumatoid arthritis patients treated with anti-tumor necrosis factor alpha monoclonal antibody (cA2)." Arthritis and Rheumatism 41, no. 12 (December 1998): 2205-2210.

PMID
9870877
Full Text

Hansen, KE, and St Clair, EW. "Disseminated histoplasmosis in systemic lupus erythematosus: case report and review of the literature." Semin Arthritis Rheum 28, no. 3 (December 1998): 193-199. (Review)

PMID
9872480
Scholars@Duke

Cooper, GS, Dooley, MA, Treadwell, EL, St Clair, EW, Parks, CG, and Gilkeson, GS. "Hormonal, environmental, and infectious risk factors for developing systemic lupus erythematosus." Arthritis and rheumatism 41, no. 10 (October 1998): 1714-1724. (Academic Article)

Full Text

Cooper, GS, Dooley, MA, Treadwell, EL, St Clair, EW, Parks, CG, and Gilkeson, GS. "Hormonal, environmental, and infectious risk factors for developing systemic lupus erythematosus." Arthritis and Rheumatism 41, no. 10 (October 1998): 1714-1724. (Review)

PMID
9778212
Full Text

St Clair, EW, Moak, SA, Wilkinson, WE, Sanders, L, Lang, T, and Greenwald, RA. "A cross sectional analysis of 5 different markers of collagen degradation in rheumatoid arthritis." J Rheumatol 25, no. 8 (August 1998): 1472-1479.

PMID
9712086
Scholars@Duke

St Clair, EW. "Nitric oxide--friend or foe in arthritis?." J Rheumatol 25, no. 8 (August 1998): 1451-1453.

PMID
9712081
Scholars@Duke

Barnett, ML, Kremer, JM, St. Clair, EW, Clegg, DO, Furst, D, Weisman, M, Fletcher, MJF, Chasan-Taber, S, Finger, E, Morales, A, Le, CH, and Trentham, DE. "Treatment of rheumatoid arthritis with oral type II collagen: Results of a multicenter, double-blind, placebo-controlled trial." Arthritis and Rheumatism 41, no. 2 (February 1, 1998): 290-297.

Full Text

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