Project Grant K24AR084072

K24 ADVANCING REPRODUCTIVE RHEUMATOLOGY - ABSTRACT: INSUFFICIENT RESEARCH EXISTS ON THE REPRODUCTIVE HEALTH OF WOMEN WITH RHEUMATIC DISEASE, LEAVING YOUNG WOMEN WITHOUT RELIABLE GUIDANCE REGARDING CONTRACEPTION AND PREGNANCY. THIS KNOWLEDGE GAP HAS RESULTED IN ALARMING STATISTICS: 15% OF PREGNANCIES IN WOMEN WITH RHEUMATIC DISEASE OCCUR WHILE TAKING TERATOGENS, INCREASING THE RISK OF PREGNANCY LOSS TO 40% AND BIRTH DEFECTS TO 25%. MOREOVER, WOMEN WITH SLE EXPERIENCE PRETERM BIRTH AND PREECLAMPSIA RATES THAT ARE 3-6 TIMES HIGHER THAN HEALTHY WOMEN AND HAVE REMAINED STAGNANT FOR TWO DECADES. THE SCARCITY OF TRAINED RESEARCHERS AND MENTORS POSES A SIGNIFICANT OBSTACLE TO PROGRESS IN THIS FIELD. TO ADDRESS THESE CHALLENGES, THIS PROPOSAL AIMS TO ENHANCE THE SCIENTIFIC RIGOR OF RESEARCH AND EXPAND THE WORKFORCE OF CLINICIAN-SCIENTISTS IN REPRODUCTIVE RHEUMATOLOGY THROUGH MENTORING AND HANDS-ON RESEARCH. DR. CLOWSE, A LEADING REPRODUCTIVE RHEUMATOLOGIST, IS EXCEPTIONALLY QUALIFIED TO BRIDGE THESE GAPS. SHE HAS MULTIPLE FEDERALLY-FUNDED GRANTS, DELIVERS LECTURES WORLDWIDE, PUBLISHES EXTENSIVELY, AND MENTORS NUMEROUS TRAINEES. DR. CLOWSE WILL LEVERAGE HER UNIQUE RESEARCH PLATFORMS TO PROVIDE MENTEES WITH PRACTICAL RESEARCH EXPERIENCE THROUGH TWO APPROACHES: 1.) IDENTIFYING RISK FACTORS FOR ADVERSE PREGNANCY OUTCOMES AND 2.) DEVELOPING AND TESTING CLINICAL TOOLS TO ENHANCE REPRODUCTIVE RHEUMATOLOGY CARE. THESE PROJECTS WILL EXPOSE TRAINEES TO OUTCOMES AND BIOMARKER ANALYSIS, QUALITATIVE STUDIES, AND IMPLEMENTATION SCIENCE, THEREBY EQUIPPING THEM WITH THE DIVERSE SKILL SET NECESSARY FOR ADDRESSING THE BROAD RANGE OF CLINICAL QUESTIONS IN THIS FIELD. ADDITIONALLY, MENTEES WILL GAIN FIRSTHAND EXPERIENCE IN PATIENT-CENTERED RESEARCH THROUGH REGULAR MEETINGS WITH A PATIENT COLLABORATOR GROUP. THEY WILL DEVELOP SKILLS IN DISSEMINATING RESEARCH FINDINGS THROUGH MANUSCRIPTS, ORAL PRESENTATIONS, AND CONTENT CREATION FOR WIDELY-USED WEBSITES. TO FOSTER THE NASCENT REPRODUCTIVE RHEUMATOLOGY COMMUNITY AND EXTEND MENTORING BEYOND DUKE UNIVERSITY, DR. CLOWSE WILL HOST A NEW REPRODUCTIVE RHEUMATOLOGY NATIONAL LAB MEETING AS A MONTHLY TELECONFERENCE WITH THE GOAL OF INCREASING THE RIGOR OF RESEARCH AND FACILITATE COLLABORATION WITHIN THE COMMUNITY. NEW RESEARCH IN THIS PROPOSAL WILL TARGET ACTIVE LUPUS NEPHRITIS DURING PREGNANCY, AS IT POSES A SERIOUS THREAT TO THE LIVES AND LONG-TERM HEALTH OF MOTHER AND CHILD. WITH NEW TREATMENTS FOR NEPHRITIS, THERE IS AN OPPORTUNITY TO IMPROVE OUTCOMES, PROVIDED THAT PREGNANT WOMEN RECEIVE OPTIMAL TREATMENT. DR. CLOWSE WILL DEVELOP A PATIENT-CENTERED, DATA-DRIVEN DECISION TOOL TO GUIDE THE TREATMENT OF ACTIVE LUPUS NEPHRITIS DURING PREGNANCY WITH THE GOAL OF TRANSFORMING CARE IN THESE HIGH-RISK PREGNANCIES. OVER THE NEXT FIVE YEARS, DR. CLOWSE WILL TRAIN CLINICIAN-SCIENTISTS IN REPRODUCTIVE RHEUMATOLOGY, PUBLISH NOVEL FINDINGS, DEVELOP DECISION TOOLS, AND ESTABLISH A COLLABORATIVE MENTORING PROGRAM. BY EXPANDING HER MENTORING SKILLS, SHE WILL EFFECTIVELY GUIDE JUNIOR INVESTIGATORS TOWARDS INDEPENDENCE WHILE CULTIVATING A SKILLED AND RESILIENT WORKFORCE IN REPRODUCTIVE RHEUMATOLOGY. THIS NEXT GENERATION OF EXPERTS WILL BE WELL-PREPARED TO ADDRESS CRITICAL CLINICAL QUESTIONS, ULTIMATELY IMPROVING THE HEALTH OF WOMEN AND THEIR CHILDREN.