The career objective of the K23 candidate is to become a rheumatic disease epidemiologist. In the context of mentored research, Dr. Curtis will examine the incidence, risk factors, and outcomes related to osteoporosis, with an emphasis on African Americans and men. To achieve this objective, Dr. Curtis has designed a didactic training program to augment his methodologic skills in analytic techniques relevant to large longitudinal studies. With supervision of experienced mentors, Dr. Curtis will obtain hands-on training in the conduct and analysis of an ancillary study to the 4 year R01 """"""""Reasons for Geographic and Racial Differences in Stroke"""""""" study funded by the NINDS enrolling 30,000 African Americans and Caucasians. Although typically at lower risk for fractures than Caucasian women, African Americans and men suffer greater post-fracture morbidity and mortality. The ability to estimate absolute fracture risk among men and non-Caucasians is limited since these persons are relatively underrepresented in osteoporosis cohorts. Prior fracture appears to be an independent risk for subsequent stroke and myocardial infarction (Ml), but the association between bone and vascular disease in high risk, understudied populations is poorly understood.
The specific aims of the K23 project are 1) Define ethnic/racial differences in relative and absolute fracture incidence over 4 years in 3 high risk groups (prevalent fracture; prior stroke; glucocorticoid use) compared to the overall cohort; 2) Determine ethnic/racial differences in stroke and Ml risk among those with prevalent fracture. Survival analysis will compare rates and risk factors for first and recurrent fractures and vascular events by ethnicity/race and gender. Shared risk factors for both bone and vascular disease will be examined in several secondary hypotheses based on an ancillary questionnaire sent to the entire cohort. Data generated from this project will provide a framework for future research proposals. Better understanding of the absolute and relative hazards associated with risk factors for fracture and associated vascular events in African Americans and men may lead to improved understanding of the underlying biology and help reduce ethnic/racial and gender-related disparities in osteoporosis care. Beyond the training objective of this award, the ultimate goal is better prevention through improved identification of those at highest risk for poor outcomes from osteoporotic fractures and associated vascular disease. ? ? ? ?
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|Charles-Schoeman, Christina; Wang, Xiaoyan; Lee, Yuen Yin et al. (2016) Association of Triple Therapy With Improvement in Cholesterol Profiles Over Two-Year Followup in the Treatment of Early Aggressive Rheumatoid Arthritis Trial. Arthritis Rheumatol 68:577-86|
|Herrinton, Lisa J; Harrold, Leslie; Salman, Craig et al. (2016) Population Variations in Rheumatoid Arthritis Treatment and Outcomes, Northern California, 1998-2009. Perm J 20:4-12|
|Navarro-Millán, Iris; Yang, Shuo; DuVall, Scott L et al. (2016) Association of hyperlipidaemia, inflammation and serological status and coronary heart disease among patients with rheumatoid arthritis: data from the National Veterans Health Administration. Ann Rheum Dis 75:341-7|
|Pappas, Dimitrios A; John, Ani; Curtis, Jeffrey R et al. (2016) Dosing of Intravenous Tocilizumab in a Real-World Setting of Rheumatoid Arthritis: Analyses from the Corrona Registry. Rheumatol Ther 3:103-115|
|Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M et al. (2016) Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting. Perm J 20:4-10|
|Sieberts, Solveig K; Zhu, Fan; García-García, Javier et al. (2016) Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis. Nat Commun 7:12460|
|Navarro-Millán, Iris; Herrinton, Lisa J; Chen, Lang et al. (2016) Comparative Effectiveness of Etanercept and Adalimumab in Patient Reported Outcomes and Injection-Related Tolerability. PLoS One 11:e0149781|
|Unni, S; Yao, Y; Milne, N et al. (2015) An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database. Osteoporos Int 26:581-7|
|Curtis, J R; Yang, S; Chen, L et al. (2015) Determining the Minimally Important Difference in the Clinical Disease Activity Index for Improvement and Worsening in Early Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken) 67:1345-53|
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