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: 8307483
• 负责人: Seoyoung Catherine Kim
• 金额: $ 13.57万
• 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/8307483
• 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; 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; 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.

描述（由申请人提供）：我是布莱根妇女医院 (BWH) 药物流行病学和药物经济学科以及风湿病学、免疫学和过敏科的风湿病学家和博士后研究员，正在接受风湿病药物流行病学培训。博士的指导。丹尼尔·H·所罗门和塞巴斯蒂安·施尼维斯。我的长期目标是成为一名独立的药物流行病学研究员，在风湿性疾病药物的安全性方面拥有专业知识。 先前的研究表明，患有系统性红斑狼疮、系统性硬化症和溃疡性结肠炎等免疫功能低下疾病的女性患宫颈发育不良和人乳头瘤病毒（HPV）感染的风险比一般人群中的女性更高。然而，关于类风湿性关节炎 (RA) 中宫颈发育不良和 HPV 感染风险的数据很少。我建议使用几种综合方法来评估 RA 患者患宫颈发育不良、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（即传统的缓解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，并检查 RA 患者对现行宫颈癌筛查指南的遵守情况。我将使用不同的数据源，包括电子病历、大型管理数据库、患者调查以及患者登记。 随着宫颈癌疫苗的出现，识别高危女性具有重大的公共卫生意义。拟议的研究有助于更好地了解接受免疫抑制治疗的 RA 患者感染 HPV、宫颈发育不良和宫颈癌的风险。此外，它还强调了对宫颈癌进行常规监测的重要性，这可能会改善对这种潜在致命但可预防疾病的监测和管理。 BWH 的药物流行病学和风湿病学部门是我追求研究目标和长期职业目标的理想环境。药物流行病学部是国际知名的药物流行病学研究卓越中心，并从各种跨学科角度促进与药物使用和结果相关的广泛活动。风湿病科每年为 30,000 多名患者提供优质的临床护理，并拥有大量的 RA 患者前瞻性登记资料。风湿病科临床科学部在 Solomon 博士的指导下，以在临床研究方面的卓越表现而闻名，重点关注 RA 研究。两个部门都拥有宝贵的资源，包括空间、设备和知识渊博的教师（包括 RA 研究和药物流行病学专家），以帮助我实现目标。