Massachusetts General Hospital

The Rheumatology Clinical Research Unit (RCRU) at Massachusetts General Hospital (MGH) is directed by John Stone, MD, MPH.  The RCRU is located on the second floor of the Yawkey Building within Rheumatology Associates, consistent with the philosophy that clinical research needs to be brought to patients.  The RCRU is staffed by clinical investigators whose interests range broadly and include systemic lupus erythematosus (SLE), systemic vasculitis, gout, Lyme disease, rheumatoid arthritis (RA), Sjögren’s syndrome, osteoarthritis, IgG4-related systemic disease, and metabolic bone disease (Paget’s disease, osteoporosis).  The RCRU has a close relationship with the Mass General Clinical Research Center, which provides study coordinators, biostatistical analysis, trial design consultation, and data management services.    

The major focus of the RCRU is "translational research", i.e., the type of investigation that applies breakthroughs in the laboratory directly to medical diseases in human patients.  Recent examples of the types of work at the MGH include:

• Leadership on a multicenter, randomized, double-blind clinical trial of rituximab in ANCA-associated vasculitis;
• An investigation of genes associated with B cell activation in RA and SLE;
• A study of novel autoantigens in early RA;
• The first prospective clinical trial in IgG4-related systemic disease;
• Novel therapeutic approaches to SLE (e.g., interference with the disease’s interferon signature)

The RCRU has developed productive collaborations with the Center for Inflammatory and Immunological Diseases (CIID), ensuring that state-of-the-art scientific techniques are brought from the laboratory bench to the patient’s bedside for the purposes of more efficient diagnosis and more effective therapies. 

Studies currently recruiting:

• RA
• IgG4-RSD
• Osteoarthritis
• SLE
• Giant cell arteritis
• Paget’s disease

Rituximab versus Cyclophosphamide for ANCA-associated vasculitis. (PDF)

Stone JH, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CGM, St. Clair EW, Turkiewicz A, Tchao NK, Webber L, Ding L, Sejismundo LP, Mieras K, Weitzenkamp D, Ikle D, Seyfert-Margolis V, Mueller M, Brunetta P, Allen NB, Fervenza FC, Geetha D, Keogh KA, Kissin EY, Monach PA, Peikert T, Stegeman C, Ytterberg SR and Specks U, for the RAVE-ITN Research Group.  N Engl J Med 2010; 363: 221-32.

Functionally defective germline variants of sialic acid acetylesterase in autoimmunity. (PDF)

Surolia I, Pirnie SP, Chellappa V, Taylor KN, Cariappa A, Moya J, Liu H, Bell DW, Driscoll DR, Diederichs S, Haider K, Netravali I, Le S, Elia R, Lee A, Freudenberg J, De Jager PL, Chretien Y, Varki A, MacDonald ME, Gillis T, Behrens TW, Bloch D, Collier D, Korzenik J, Podolsky DK, Hafler D, Murali M, Sands B, Stone JH, Gregersen PK, Pillai S. Nature 2010; 466 : 243-7.

Relationship between immunity to Borrelia burgdorferi outer-surface protein A (OspA) and Lyme arthritis. (PDF)

Steere AC, Drouin EE, Glickstein LJ.  Clin Infect Dis. 2011; 52: s259-65.

Peptides presented by HLA-DR molecules in synovia of patients with rheumatoid arthritis or antibiotic-refractory Lyme arthritis. (PDF)

Seward RJ, Drouin EE, Steere AC, Costello CE.  Mol Cell Proteomics 2011; 10: M110.002477.

Treatment of primary Sjogren syndrome. A systematic review. (PDF)

Ramos-Casals M, Tzioufas AG, Stone JH, Siso A, Bosch X.  JAMA 2010; 304: 452-60.

Treg cell numbers and function in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. (PDF)

Shen S, Shin JJ, Strle K, McHugh G, Li X, Glickstein LJ, Drouin EE, Steere AC.  Arthritis & Rheum 2010; 62: 2127-37.

2-tiered antibody testing for early and late Lyme disease using only an immunoglobulin G blot with the addition of a VlsE band as the second-tier test. (PDF)

Branda JA, Aguero-Rosenfeld ME, Ferraro MJ, Johnson BJ, Wormser GP, Steere AC.  Clin Infect Dis. 2010; 50: 20-6.

Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum. (PDF)

Dahlgren M, Khosroshahi A, Nielsen GP, Deshpande V, Stone JH.  Arthritis Care & Research 2010; 62: 1312-8.

Rituximab therapy leads to rapid decline of serum IgG4 levels and prompt clinical improvement in IgG4-related systemic disease. (PDF)

Khosroshahi A, Bloch DB, Deshpande V, Stone JH.  Arthritis & Rheum 2010; 62: 1755-62.