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

Hinkofer, LC, Hummel, AM, Stone, JH, Hoffman, GS, Merkel, PA, Spiera, ERF, St Clair, W, McCune, JW, Davis, JC, Specks, U, and Jenne, DE. "Allosteric modulation of proteinase 3 activity by anti-neutrophil cytoplasmic antibodies in granulomatosis with polyangiitis." Journal of autoimmunity 59 (May 2015): 43-52.

PMID
25744251
Full Text

Geetha, D, Specks, U, Stone, JH, Merkel, PA, Seo, P, Spiera, R, Langford, CA, Hoffman, GS, Kallenberg, CGM, St Clair, EW, Fessler, BJ, Ding, L, Tchao, NK, Ikle, D, Jepson, B, Brunetta, P, Fervenza, FC, and Rituximab for ANCA-Associated Vasculitis Immune Tolerance Network Research Group, . "Rituximab versus cyclophosphamide for ANCA-associated vasculitis with renal involvement." Journal of the American Society of Nephrology : JASN 26, no. 4 (April 2015): 976-985.

PMID
25381429
Full Text

Unizony, S, Lim, N, Phippard, DJ, Carey, VJ, Miloslavsky, EM, Tchao, NK, Iklé, D, Asare, AL, Merkel, PA, Monach, PA, Seo, P, St Clair, EW, Langford, CA, Spiera, R, Hoffman, GS, Kallenberg, CGM, Specks, U, and Stone, JH. "Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis." Arthritis & rheumatology (Hoboken, N.J.) 67, no. 2 (February 2015): 535-544.

PMID
25332071
Full Text

Huffman, KM, Pieper, CF, Hall, KS, St Clair, EW, and Kraus, WE. "Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis." Scandinavian journal of rheumatology 44, no. 2 (January 2015): 106-110.

PMID
25222824
Full Text

Dye, JR, Kaul, MS, and St Clair, EW. "Inflammatory Diseases of the Coronary Arteries." In PanVascular Medicine, Second Edition, 1885-1916. January 1, 2015.

Full Text

Smilek, DE, and St Clair, EW. "Solving the puzzle of autoimmunity: critical questions." F1000prime reports 7 (January 2015): 17-. (Review)

PMID
25750735
Full Text

Miloslavsky, EM, Specks, U, Merkel, PA, Seo, P, Spiera, R, Langford, CA, Hoffman, GS, Kallenberg, CGM, St Clair, EW, Tchao, NK, Viviano, L, Ding, L, Iklé, D, Villarreal, M, Jepson, B, Brunetta, P, Allen, NB, Fervenza, FC, Geetha, D, Keogh, K, Kissin, EY, Monach, PA, Peikert, T, Stegeman, C, Ytterberg, SR, Stone, JH, and Rituximab in ANCA-Associated Vasculitis-Immune Tolerance Network Research Group, . "Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis." Arthritis & rheumatology (Hoboken, N.J.) 66, no. 11 (November 2014): 3151-3159.

PMID
25047592
Full Text

AbouAssi, H, Tune, KN, Gilmore, B, Bateman, LA, McDaniel, G, Muehlbauer, M, Huebner, JL, Hoenig, HM, Kraus, VB, St Clair, EW, Kraus, WE, and Huffman, KM. "Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis." The Journal of rheumatology 41, no. 10 (October 2014): 1974-1979.

PMID
24986846
Full Text

Hershberg, U, Meng, W, Zhang, B, Haff, N, St Clair, EW, Cohen, PL, McNair, PD, Li, L, Levesque, MC, and Luning Prak, ET. "Persistence and selection of an expanded B-cell clone in the setting of rituximab therapy for Sjögren's syndrome." Arthritis research & therapy 16, no. 1 (February 11, 2014): R51-.

PMID
24517398
Full Text

Batich, KA, William St Clair, E, McLendon, RE, and Sampson, JH. "Complete response to steroids in dural inflammatory pseudotumor associated with Still's disease." J Clin Neurosci 20, no. 10 (October 2013): 1445-1448.

PMID
23768965
Full Text

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