Dr. Karen Costenbader is a recognized patient-oriented investigator in the epidemiology and outcomes of systemic lupus erythematosus and rheumatoid arthritis, and a very engaged mentor of the next generation of patient-oriented clinical investigators. She has served as primary or secondary research mentor for 40 pre- and post-doctoral research trainees. Along with her position as Director of the Brigham and Women's Hospital Lupus Program, Dr. Costenbader's mentoring is facilitated by her affiliations with multiple Harvard-based institutions and training programs, and with national research and clinical organizations. The candidate's many ongoing patient-oriented research projects and collaborations, high degree of commitment to mentoring and to continuing to improve her mentoring skills, and the exceptional institutional resources, provide an outstanding environment for the development of junior investigators. This K24 grant would preserve Dr. Costenbader's protected time and relieve her of clinical and administrative responsibilities. The new research aims proposed will build upon past work on cardiovascular disease risk among lupus patients. With data on more than 100,000 lupus patients enrolled in Medicaid in the U.S., the new studies will address key unanswered questions about lupus disease heterogeneity and cardiovascular disease risk, with abundant statistical power to detect differences in these serious outcomes. The inherent sociodemographic variation of this population and the high risk of cardiovascular disease in this vulnerable population make these studies extremely relevant for improving care and outcomes for lupus patients. Additionally, validating and refining the 2017 QRISK3 cardiovascular disease risk prediction algorithm in the Brigham and Women's Lupus Cohort will provide patient interactions to collect and verify outcomes, and experience for mentees with developing risk prediction algorithms. The clinical questions to be examined will afford independent projects and publications, experience with advanced biostatistical models for research mentees, and excellent mentoring opportunities. Dr. Costenbader has assembled a strong team of highly qualified co-mentors and she will recruit two to three new trainees into her rheumatic disease epidemiology and outcomes research program annually. She will continue to refine her mentoring program and skills using trainee feedback and the many educational opportunities in her environment. This K24 grant would support Dr. Costenbader's ability to develop the next generation of patient-oriented rheumatic disease investigators.

Public Health Relevance

Dr. Karen Costenbader is a recognized patient-oriented investigator in the study of rheumatic diseases, in particular systemic lupus erythematosus and rheumatoid arthritis, and a very engaged research mentor. The new research proposed on cardiovascular disease risks and outcomes among patients with lupus in the U.S. has great public health relevance and will afford excellent mentoring opportunities. With strong institutional commitment and resources, a strong highly-qualified co-mentoring team, and her past success in training academic clinical investigators, this K24 grant would relieve Dr. Costenbader of clinical and administrative responsibilities and greatly support her ability to mentor the next generation of well-trained leaders in patient- oriented rheumatic disease research.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Special Emphasis Panel (ZAR1)
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Witter, James
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Brigham and Women's Hospital
United States
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Feldman, Candace H; Costenbader, Karen H; Solomon, Daniel H et al. (2018) Area-level Predictors of Medication Nonadherence among U.S. Medicaid Beneficiaries with Lupus: A Multilevel Study. Arthritis Care Res (Hoboken) :
Barbhaiya, Medha; Feldman, Candace H; Guan, Hongshu et al. (2018) Racial/ethnic variation in stroke rates and risks among patients with systemic lupus erythematosus. Semin Arthritis Rheum :
Broder, Anna; Mowrey, Wenzhu B; Golestaneh, Ladan et al. (2018) Methodological considerations in comparing access to Pre-emptive renal transplantation between SLE and other ESRD causes in the USRDS. Semin Arthritis Rheum :
Feldman, Candace H; Collins, Jamie; Zhang, Zhi et al. (2018) Dynamic patterns and predictors of hydroxychloroquine nonadherence among Medicaid beneficiaries with systemic lupus erythematosus. Semin Arthritis Rheum 48:205-213
MacFarlane, Lindsey A; Kim, Eunjung; Cook, Nancy R et al. (2018) Racial Variation in Total Knee Replacement in a Diverse Nationwide Clinical Trial. J Clin Rheumatol 24:1-5
Feldman, Candace H; Broder, Anna; Guan, Hongshu et al. (2018) Sex Differences in Health Care Utilization, End-Stage Renal Disease, and Mortality Among Medicaid Beneficiaries With Incident Lupus Nephritis. Arthritis Rheumatol 70:417-426
Tedeschi, Sara K; Johnson, Sindhu R; Boumpas, Dimitrios et al. (2018) Developing and Refining New Candidate Criteria for Systemic Lupus Erythematosus Classification: An International Collaboration. Arthritis Care Res (Hoboken) 70:571-581
Lin, Tzu-Chieh; Marmor, Michael F; Barbhaiya, Medha et al. (2018) Baseline Retinal Examinations in Patients With Systemic Lupus Erythematosus Newly Initiating Hydroxychloroquine Treatment in a US Medicaid Systemic Lupus Erythematosus Population, 2000-2010. Arthritis Care Res (Hoboken) 70:1700-1706
Cohen, E M; D'Silva, K; Kreps, D et al. (2018) Arthritis and use of hydroxychloroquine associated with a decreased risk of macrophage activation syndrome among adult patients hospitalized with systemic lupus erythematosus. Lupus 27:1065-1071
Sparks, Jeffrey A; Lin, Tzu-Chieh; Camargo Jr, Carlos A et al. (2018) 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 47:639-648

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