Dr. Mikuls' career goals are to participate in meaningful investigations of the epidemiology and outcomes of musculoskeletal disorders and in the process develop an independent career in clinical research with consistent NIH funding. In order to meet his immediate and long-term objectives, the applicant has proposed a career development plan that relies predominantly on hands-on research experience with cohort design, management, and analysis. Didactic training will include seminars and face-to-face mentoring sessions with experienced NIH-funded investigators. The career development training will cover areas that are directly pertinent to the proposed research project. This project includes cross-sectional and prospective evaluations of patients with RA participating in the NIH-funded Consortium for the Longitudinal Evaluation of African- Americans with eady Rheumatoid Arthritis (CLEAR) the VA Rheumatoid Arthritis (VARA) registries.
The aims of the study are: 1) to determine baseline lumbar spine and femoral neck bone mineral density (BMD) values and osteopenia / osteoporosis prevalence among AA patients with early RA and among male veterans with established disease and, 2) to identify environmental factors and candidate alleles, which confer increased risk of reduced baseline BMD and BMD loss over time among AA patients with early RA and among male veterans with established disease. Subjects will undergo bone mineral density (BMD) measurement of the femur and lumbar spine via duel energy x-ray absorptiometry at the time of enrollment and again after a standard period of follow-up (2 years for VARA, 3 to 5 years for CLEAR). Baseline BMD measurements will be compared in a cross-sectional manner with normative data from the National Health and Nutrition Examination Survey (NHANES) III and from Hologic, Inc. Longitudinal comparisons in BMD will be made among post-menopausal AA women with IRA with data from the prospective Women's Health Initiative (WIll). Using mulitvadable modeling we will examine the role of candidate alleles and environmental factors (particularly glucocorticoid use) as determinants of BMD and BMD loss. This cohort study will greatly enhance our understanding of RA-associated bone loss in traditionally understudied populations and will provide an optimal context for Dr. Mikuls' continued development as an independent clinical investigator.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AR050004-02
Application #
6944873
Study Section
Special Emphasis Panel (ZAR1-GHN-B (M1))
Program Officer
Serrate-Sztein, Susana
Project Start
2004-08-27
Project End
2009-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
2
Fiscal Year
2005
Total Cost
$100,554
Indirect Cost
Name
University of Nebraska Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
168559177
City
Omaha
State
NE
Country
United States
Zip Code
68198
Mikuls, Ted R; Levan, Tricia; Gould, Karen A et al. (2012) Impact of interactions of cigarette smoking with NAT2 polymorphisms on rheumatoid arthritis risk in African Americans. Arthritis Rheum 64:655-64
Mikuls, Ted R; Fay, Brian T; Michaud, Kaleb et al. (2011) Associations of disease activity and treatments with mortality in men with rheumatoid arthritis: results from the VARA registry. Rheumatology (Oxford) 50:101-9
Craig, Steven M; Yu, Fang; Curtis, Jeffrey R et al. (2010) Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis. J Rheumatol 37:275-81
Mikuls, Ted R; Sayles, Harlan; Yu, Fang et al. (2010) Associations of cigarette smoking with rheumatoid arthritis in African Americans. Arthritis Rheum 62:3560-8
Miriovsky, Benjamin J; Michaud, Kaleb; Thiele, Geoffrey M et al. (2010) Anti-CCP antibody and rheumatoid factor concentrations predict greater disease activity in men with rheumatoid arthritis. Ann Rheum Dis 69:1292-7
Mikuls, Ted R; Payne, Jeffrey B; Reinhardt, Richard A et al. (2009) Antibody responses to Porphyromonas gingivalis (P. gingivalis) in subjects with rheumatoid arthritis and periodontitis. Int Immunopharmacol 9:38-42
Curtis, J R; Arora, T; Donaldson, M et al. (2009) Skeletal health among African Americans with recent-onset rheumatoid arthritis. Arthritis Rheum 61:1379-86
Mikuls, T R; Hughes, L B; Westfall, A O et al. (2008) Cigarette smoking, disease severity and autoantibody expression in African Americans with recent-onset rheumatoid arthritis. Ann Rheum Dis 67:1529-34
Mikuls, Ted R; Holers, V Michael; Parrish, Lezlie et al. (2006) Anti-cyclic citrullinated peptide antibody and rheumatoid factor isotypes in African Americans with early rheumatoid arthritis. Arthritis Rheum 54:3057-9
Mikuls, Ted R; Saag, Kenneth G; Curtis, Jeffrey et al. (2005) Prevalence of osteoporosis and osteopenia among African Americans with early rheumatoid arthritis: the impact of ethnic-specific normative data. J Natl Med Assoc 97:1155-60