Cervical Dysplasia and Human Papillomavirus Infection in Rheumatoid Arthritis.

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，识别高危女性具有重要意义

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