Nearly all investigators in our group are involved with studies on the epidemiology and outcomes of rheumatoid arthritis. Past studies include identifying a key environmental risk factor for RA – smoking, and associations between reproductive factors and risk of RA among women. Current studies range from understanding the association between air pollution and RA, the association between alcohol and RA, identifying biomarkers in pre-clinical RA, and understanding gene-environment interactions in RA to pharmacogenetics of RA and understanding genetic predictors of cardiovascular disease and other outcomes in RA. Our studies utilize cohorts based at Brigham and Women's Hospital such as the Nurses' Health Study, BRASS, and the i2b2 RA cohort as well as others in conjunction with our collaborators.
The BWH Lupus Center has a strong history of SLE clinical research. Clinical investigators have studied and published on race, socioeconomic status, and psychosocial risk factors for SLE outcomes, and developed methodologic tools to assess SLE symptoms, disease activity, and damage. Epidemiologic studies have identified risk factors for SLE and for outcomes among those suffering from SLE, including cardiovascular disease, nephritis and lymphoma. In addition to the large and well-characterized SLE population of over 1800 patients followed at the BWH and strong collaborations with other specialists at BWH, clinical researchers within the Section of Clinical Sciences also have research ties with other SLE centers, as well as access to large prospective cohorts, such as the Nurses’ Health Study, and large administrative databases, including the US Renal Database. Click on the logo above to learn more about the BWH Lupus Center.
Our research focuses on the inflammatory and non-inflammatory components of pain in the rheumatic diseases. Pain is the number one priority of most patients who see rheumatologists, but, even with good control of inflammatory disease activity, many patients still have pain. Our studies use quantitative sensory testing methods to examine the role of central pain processing mechanisms on pain sensitivity. Our data suggest that patients with rheumatoid arthritis and osteoarthritis have deficits in central pain processing that increase their sensitivity to pain. This increased sensitivity may be related to non-inflammatory factors, such as sleep and mood. We are currently conducting the Save-RA trial to study the effects of milnacipran, an FDA-approved drug for the treatment of fibromyalgia, in rheumatoid arthritis.
Our section conducts ongoing investigation into the link between cardiovascular disease and the rheumatic diseases. Earlier studies by members of the Section helped to identify that there was an increased risk of cardiovascular disease (CVD) in specific rheumatic diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Ongoing research in our Section focuses on what may be leading to the increased risk of genetics, treatment or environmental exposures and the interactions between these factors that can lead to increased risk of CVD.
In 2004, the Brigham and Women's Lyme Disease Prevention Program was established to educate the higher risk target population of school-aged children on preventative measures that can reduce the risk of Lyme disease. Originally funded by a grant through the Center for Disease Control, this program has travelled to over 20 schools and educated over 4,000 children in the greater Boston area. The study’s findings revealed that children experience high incidence of Lyme disease, yet educational interventions among at-risk school children remain rare. Due to the success of these educational and interactive talks, the preventative program has since merged with school staff and other public health organizations.