Cervical Dysplasia and Human Papillomavirus Infection in Rheumatoid Arthritis.

类风湿关节炎中的宫颈发育不良和人乳头瘤病毒感染。

• 批准号: 7950340
• 负责人: Seoyoung Catherine Kim
• 金额: $ 13.65万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7950340
• 关键词: Academic Medical Centers; Address; Adherence; Algorithms; Anogenital Human Papilloma Virus Infection; Antirheumatic Agents; Behavioral; Biological Response Modifier Therapy; Cervical Cancer Screening; Cervical cancer vaccine; Cervical dysplasia; Chronic; Clinical; Clinical Sciences; Clinical Trials; Computerized Medical Record; Data; Data Sources; Databases; Disease; Disease-Modifying Second-Line Drugs; Drug usage; Enrollment; Environment; Equipment; Etanercept; Faculty; Female; General Population; Goals; Guidelines; HPV-High Risk; Health Insurance; Herpesvirus Type 3; High Risk Woman; Hospitals; Human Papillomavirus; Human papilloma virus infection; Hypersensitivity; Immunocompromised Host; Immunology; Immunosuppressive Agents; Incidence; Infection; Inflammatory; Insurance; Lead; Life; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methodology; Oncogenic; Opportunistic Infections; Outcome; Patients; Pharmaceutical Economics; Pharmaceutical Preparations; Pharmacoepidemiology; Postdoctoral Fellow; Premalignant; Registries; Research; Research Personnel; Resources; Rheumatism; Rheumatoid Arthritis; Rheumatology; Risk; Risk Factors; Safety; Severity of illness; Sexually Transmitted Diseases; Surrogate Endpoint; Surveys; Systemic Lupus Erythematosus; Systemic Scleroderma; Testing; Therapeutic immunosuppression; Time; Training; Tumor Necrosis Factor-alpha; Tumor Necrosis Factors; Ulcerative Colitis; Vaccines; Virus; Woman; adalimumab; administrative database; career; clinical care; infliximab; inhibitor/antagonist; patient oriented research; patient registry; prospective; public health relevance; rheumatologist; rituximab; tositumomab; trend

DESCRIPTION (provided by applicant): I am a Rheumatologist and Postdoctoral Fellow in the Division of Pharmacoepidemiology and Pharmacoeconomics and the Division of Rheumatology, Immunology and Allergy at Brigham and Women's Hospital (BWH), undertaking a training in Pharmacoepidemiology in the rheumatic diseases under the guidance of Drs. Daniel H. Solomon and Sebastian Schneeweiss. My long term goal is to establish a career as an independent pharmacoepidemiology researcher with expertise in the safety of drugs used in the rheumatic diseases. Previous studies have suggested that women with immunocompromised conditions including systemic lupus erythematosus, systemic sclerosis and ulcerative colitis are at a greater risk for cervical dysplasia and human papillomavirus (HPV) infection than are women in the general population. However, scant data exist regarding the risk of cervical dysplasia and HPV infection in rheumatoid arthritis (RA). I propose to use several integrative approaches to evaluate the risk of cervical dysplasia, cervical cancer and HPV infection in patients with RA, to relate the risks of these outcomes to different types of immunosuppressive therapy (i.e., traditional disease-modifying anti-rheumatic drugs versus biologic therapy) as well as demographic and other clinical factors and to examine adherence to current cervical cancer screening guidelines in patients with RA. I will be using different data sources including electronic medical records, large administrative databases, patient survey, as well as patient registries. With the advent of the cervical cancer vaccine, identification of women at high risk carries great public health relevance. The proposed research offers a better understanding of the risk of HPV infection, cervical dysplasia, and cervical cancer in RA patients on immunosuppressive treatments. In addition, it emphasizes the importance of routine surveillance of cervical cancer, which could lead to improvement in the surveillance and management of this potentially fatal, but preventable disease. Both Divisions of Pharmacoepidemiology and Rheumatology at BWH are the ideal environments to pursue my research aims and long term career goal. The Pharmacoepidemiology Division is internationally known as a center of excellence in pharmacoepidemiology research and facilitates a wide range of activities related to the use and outcomes of medications, addressed from a variety of interdisciplinary perspectives. The Rheumatology Division provides excellent clinical care to over 30,000 patients a year and has a large prospective registry of RA patients. The Section of Clinical Sciences in the Rheumatology Division, under the direction of Dr. Solomon, is renowned for excellence in clinical investigation with a focus on RA research. Both Divisions have valuable resources including space, equipment, and knowledgeable faculty including experts in RA research as well as pharmacoepidemiology to help me achieve my goals.

简介(申请人提供)：我是布里格姆妇女医院(BWH)药物流行病学和药物经济学及风湿病学、免疫学和过敏科的风湿病学家和博士后研究员，在Daniel H.所罗门博士和Sebastian Schneweiss博士的指导下进行风湿疾病的药物流行病学培训。我的长期目标是成为一名独立的药物流行病学研究员，在风湿性疾病中使用的药物的安全性方面拥有专业知识。先前的研究表明，免疫功能受损的女性，包括系统性红斑狼疮、系统性硬化症和溃疡性结肠炎，比普通女性患宫颈发育不良和人类乳头瘤病毒(HPV)感染的风险更大。然而，关于类风湿性关节炎(RA)中宫颈发育不良和HPV感染的风险的数据很少。我建议使用几种综合方法来评估RA患者宫颈异型增生、宫颈癌和HPV感染的风险，将这些结果的风险与不同类型的免疫抑制治疗(即传统的治疗疾病的抗风湿药物与生物治疗)以及人口统计和其他临床因素相关联，并检查RA患者遵守当前宫颈癌筛查指南的情况。我将使用不同的数据源，包括电子病历、大型行政数据库、患者调查以及患者登记。随着宫颈癌疫苗的问世，识别高危妇女具有重大的公共卫生意义。这项拟议的研究为接受免疫抑制治疗的RA患者更好地了解了HPV感染、宫颈不典型增生和宫颈癌的风险。此外，它还强调了对宫颈癌进行常规监测的重要性，这可能有助于改善对这种可能致命但可预防的疾病的监测和管理。BWH的药物流行病学和风湿病学系都是我追求研究目标和长期职业目标的理想环境。药物流行病学分部是国际上公认的药物流行病学研究的卓越中心，从不同的跨学科角度促进与药物的使用和结果有关的广泛活动。风湿科每年为30,000多名患者提供出色的临床护理，并拥有大量预期的RA患者登记。风湿科的临床科学科在所罗门博士的指导下，以专注于类风湿关节炎研究的卓越临床研究而闻名。这两个部门都有宝贵的资源，包括空间、设备和知识渊博的教职员工，包括RA研究和药物流行病学方面的专家，帮助我实现目标。