Baylor Scott & White Research Institute (BSWRI) is committed to advancing the understanding and treatment of autoimmune and inflammatory diseases. BRI has recruited Dr. John J. Cush and Dr. Kathryn Dao as leaders in clinical and translational rheumatology research. Together they have nearly 40 years of experience in rheumatic care, clinical trials, novel drug development and translational investigation.
Drs. Cush and Dao, working with the Baylor Institute for Immunology Research (BIIR), a department of Baylor Scott & White Research Institute, are participating in federally funded translational research projects and are actively involved in novel clinical trials in several therapeutic areas, including:
Rheumatoid Arthritis (RA) is a chronic inflammatory disorder that targets small and large joints but also affects other body systems with inflammation. Typically, the small joints in the hands and feet are affected, but with time progression to the large joints (e.g., the knees, ankles, hips or shoulders) may ensue. Synovial (joint) inflammation locally produces pain, swelling and stiffness but may also yield systemic effects such as fatigue, loss of appetite, fever and anemia. RA is seen in all ages but most begin to experience symptoms between 35 and 50. It affects about 1 percent of the population and mostly women. RA is a progressive disorder and, if left untreated, may result in joint damage, deformity, disability and premature death.
Baylor Research Institute–Rheumatology studies RA in several ways:
1) Clinical Trials
Drs. Cush and Dao are studying several new investigational medications that may alter RA progression while relieving the pain and disability associated with this disease. Newer therapies being tested are targeting specific immune derangements that drive rheumatoid inflammation and have the potential to halt progression and improve long-term clinical outcomes. BRI doctors have previously been involved in clinical trials that lead to FDA approval of several currently marketed medicines for RA, including Arava, Humira, Enbrel, Remicade, Cimzia, Rituxan and Actemra.
Search for Clinical Trials currently underway at Baylor Scott & White Health System.
2) National CORRONA Database
All clinic RA patients are encouraged to enroll in CORRONA – a national observational database of more than 20,000 RA patients. This database will study outcomes, drug efficacy and safety, and the natural history of those with RA. (CORRONA is not a “drug study” as all treatment choices are made by the patient and doctor – not the "study." Instead CORRONA serially records the events and treatments that naturally occur in those treated for RA).
3) Genomic Studies
BRI rheumatologists will work with scientists at BIIR to study genetically controlled immune abnormalities that accompany rheumatoid arthritis. During the clinic visit, doctors will request periodic blood samples from patients with RA (and other autoimmune disorders) to determine if microarray transcriptional profiling technology (genetic testing) can help to establish the diagnosis, inform on disease staging or severity, and assist in optimal, individualized drug selection.
More than 27 million Americans suffer from osteoarthritis, a degenerative, or “wear and tear” type of arthritis that may lead to pain, stiffness and limitation in motion. Osteoarthritis is infrequently inherited and usually results from prior trauma, fracture or, for most, the cause is unknown. Although OA does not have the destructive potential of RA, damage caused by OA is not reversible. Early diagnosis, weight reduction, exercise and treatment are important in optimizing outcomes.
Baylor Research Institute–Rheumatology is enrolling patients in studies of novel, investigational medications to improve OA pain and possibly change the progression of the disease. Dr. Cush has been active in the investigation of glucosamine, chondroitin sulfate, tart cherry extract and other nutraceuticals in OA.
Lupus is a disease of the immune system wherein the immune system attacks the body’s own tissues, including the joints, skin, blood cells, kidneys, lungs, brain and other parts of the body. Lupus affects people in different ways. Many will have only mild symptoms (joint aches, mild rashes) from time to time, or “flares,” while others may have a more aggressive, chronic disease affecting multiple organs.
Baylor Research Institute–Rheumatology is actively investigating lupus and the genetic and immunologic control of this disease. This is being done partly via our “genomic studies” (see above) with periodic analysis of blood samples from lupus patients. Moreover, BRI is recruiting lupus patients to enroll in clinical trials to study the potential benefits of newly developed therapies designed to control the immune hyperactivity and damage associated with lupus.
Still’s disease, or adult-onset Still’s disease (AOSD), is the adult expression of a pediatric inflammatory disorder called systemic-onset juvenile idiopathic arthritis (SoJIA). This highly inflammatory disorder affects children, adolescents and younger adults with daily high fevers, skin rashes and an additive polyarthritis. Those affected often look quite ill and are admitted to the hospital with a suspicion of serious infection, lung or blood conditions. These patients may also have sore throats, pleurisy, liver, spleen or lymph node enlargement and a myriad of laboratory test abnormalities that indicate nonspecific inflammation.
Baylor Research Institute–Rheumatology is actively investigating adults and children with Still’s disease. Our researchers have discovered a unique profile of immune gene expression capable of assisting in the diagnosis and delivery of highly effective biologic therapy.
Other Rheumatic Diseases
Baylor Scott & White Research Institute–Rheumatology in collaboration with the Baylor Institute Immunology Research (BIIR) is currently enrolling patients with various rheumatic diseases. Through clinical trials and the collection of blood samples from these patients we intend to study the role of transcriptional genomic profiling in defining the diagnosis, mechanisms of disease and optimal drug therapy for patients diagnosed with:
- Psoriasis and Psoriatic Arthritis
- Ankylosing Spondylitis
For more information on studies being conducted, Click Here.
Baylor Scott & White Research Institute–Rheumatology
9900 N. Central Expressway, Suite 550
Dallas, TX 75231