Since completing her rheumatology fellowship and research training, Dr. Costenbader has devoted her career to patient-oriented rheumatic disease research. She has served as primary or secondary research mentor for 33 pre- and post-doctoral trainees. Along with her position as Co-Director of the Brigham and Women's Hospital Lupus Center, Dr. Costenbader's mentoring is facilitated by her affiliations with several Harvard teaching and training programs. Moreover, the candidate's multiple ongoing patient-oriented research projects and collaborations, commitment to mentoring, and exceptional institutional resources provide an outstanding environment for the development of junior investigators in patient-oriented rheumatic disease research. This K24 grant would preserve Dr. Costenbader's protected time and relieve future clinical and administrative responsibilities. The new research aims proposed will build upon past work in a large, nationwide lupus population with Medicaid data from 2000-2010. With data on over 66,000 lupus patients in the U.S., these studies will address key unanswered questions about cardiovascular disease risks, medical and surgical care, and outcomes. These important questions include whether cardiovascular disease risks are changing over time in this population, how post-cardiac event and intervention risks compare to those of the general population, whether lupus patients receive optimal cardiac care, and whether hydroxychloroquine reduces cardiovascular disease risks. The inherent sociodemographic variation and high medical risk of this vulnerable population make these studies extremely relevant for ongoing policy discussions about improving healthcare and outcomes. The findings of these powerful studies will inform future . Moreover, the proposed research studies will provide excellent mentoring opportunities. Dr. Costenbader will continue to recruit two to three new trainees into her rheumatic disease epidemiology and outcomes research program each year, and to expand and refine her formal mentoring program using feedback received from trainees, medical care and prescribing practices and seminars and lectures at the Brigham and Women's Hospital and Harvard Medical School. Based on institutional commitment and resources and Dr. Costenbader's successful record in research and mentoring, this K24 grant would greatly augment her ability to expand her existing research mentoring program and to develop the next generation of patient-oriented rheumatic disease investigators.
K. Costenbader K24 application Dr. Costenbader is a recognized patient-oriented investigator in the epidemiology and outcomes of rheumatic diseases, in particular systemic lupus erythematosus and rheumatoid arthritis. She is very dedicated to mentoring the next generation of patient-oriented clinical investigators. Dr. Costenbader's research and mentoring opportunities are enhanced by strong affiliations with research training programs at multiple Harvard teaching hospitals, Harvard Medical School and Harvard School of Public Health, as well as with national research and clinical organizations. The new research proposed on cardiovascular disease risks and outcomes among patients with lupus in the U.S. has enormous public health relevance. Cardiovascular disease is the number one cause of death in the U.S. and despite increased rates among lupus patients, relatively little is known about recent cardiovascular disease event and mortality rates among lupus patients across the U.S., about the types of medical and surgical cardiovascular disease care received, or about outcomes after cardiac procedures for cardiovascular disease. This line of investigations has the potential to provide extremely valuable public health information concerning cardiovascular disease risks and outcomes, and medical and surgical therapies delivered in recent years across the U.S. within a large, nationwide high-risk population. Given strong institutional commitment and resources, as well as her past success in training academic clinical researchers, this K24 will support an expansion of Dr. Costenbader's research and mentoring activities, producing important research findings and well-trained leaders in patient-oriented rheumatic disease research.
|Broder, Anna; Mowrey, Wenzhu B; Izmirly, Peter et al. (2017) Validation of Systemic Lupus Erythematosus Diagnosis as the Primary Cause of Renal Failure in the US Renal Data System. Arthritis Care Res (Hoboken) 69:599-604|
|Hu, Yang; Sparks, Jeffrey A; Malspeis, Susan et al. (2017) Long-term dietary quality and risk of developing rheumatoid arthritis in women. Ann Rheum Dis 76:1357-1364|
|Sparks, Jeffrey A; Iversen, Maura D; Yu, Zhi et al. (2017) Disclosure of personalized rheumatoid arthritis risk using genetics, biomarkers, and lifestyle factors to motivate health behavior improvements:A randomized controlled trial. Arthritis Care Res (Hoboken) :|
|Bengtsson, Camilla; Malspeis, Susan; Orellana, Cecilia et al. (2017) Association Between Menopausal Factors and the Risk of Seronegative and Seropositive Rheumatoid Arthritis: Results From the Nurses' Health Studies. Arthritis Care Res (Hoboken) 69:1676-1684|
|Barbhaiya, Medha; Lu, Bing; Sparks, Jeffrey A et al. (2017) Influence of Alcohol Consumption on the Risk of Systemic Lupus Erythematosus Among Women in the Nurses' Health Study Cohorts. Arthritis Care Res (Hoboken) 69:384-392|
|Sparks, Jeffrey A; Lin, Tzu-Chieh; Camargo Jr, Carlos A et al. (2017) Rheumatoid arthritis and risk of chronic obstructive pulmonary disease or asthma among women: A marginal structural model analysis in the Nurses' Health Study. Semin Arthritis Rheum :|
|Parks, Christine G; de Souza Espindola Santos, Aline; Barbhaiya, Medha et al. (2017) Understanding the role of environmental factors in the development of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 31:306-320|
|Feldman, Candace H; Broder, Anna; Guan, Hongshu et al. (2017) Sex Differences in Healthcare Utilization, End-stage Renal Disease and Mortality among Medicaid Beneficiaries with Incident Lupus Nephritis. Arthritis Rheumatol :|
|Hiraki, Linda T; Feldman, Candace H; Marty, Francisco M et al. (2017) Serious Infection Rates Among Children With Systemic Lupus Erythematosus Enrolled in Medicaid. Arthritis Care Res (Hoboken) 69:1620-1626|
|Barbhaiya, Medha; Feldman, Candace H; Guan, Hongshu et al. (2017) Race/Ethnicity and Cardiovascular Events Among Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol 69:1823-1831|
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