Sara Tedeschi, MD, MPH
Assistant Professor of Medicine, Harvard Medical School; Associate Physician, Division of Rheumatology, Brigham and Women's Hospital
About the Researcher
Dr. Tedeschi is a rheumatologist and clinical investigator at Brigham and Women’s Hospital and an Assistant Professor of Medicine at Harvard Medical School. After receiving her medical degree from Vanderbilt University School of Medicine, she completed her internal medicine residency and rheumatology fellowship training at Brigham and Women’s Hospital.
During her rheumatology fellowship, she received a Master in Public Health degree from the Harvard T.H. Chan School of Public Health. She completed a year-long training in musculoskeletal ultrasound through the Ultrasound School of North American Rheumatologists and incorporates ultrasound into her clinical practice and research.
Dr. Tedeschi has led studies on risk factors for systemic lupus erythematosus, bone health in lupus, the relationship between diet and rheumatoid arthritis, and the use of vascular ultrasound to evaluate giant cell arteritis. Dr. Tedeschi’s current NIH-funded research focuses on methods for identifying calcium pyrophosphate crystal deposition disease (CPPD), a form of crystalline arthritis, through the use of imaging modalities and electronic health record data.
Dr. Tedeschi is a member of the Lupus Foundation of America Medical-Scientific Advisory Council. She also serves on the leadership team of the American College of Rheumatology/European League Against Rheumatism CPPD classification criteria committee and is co-chair of the OMERACT CPPD Working Group. She is the 2016 recipient of the Lupus Foundation of America's Gary S. Gilkeson Career Development Award.
"The LFA Career Development Award provided me with an opportunity to carry out two research studies aimed at better understanding bone health in lupus patients. I believe this prestigious award also stood out on my application for an NIH-funded K23 Mentored Patient-Oriented Research Career Development Award, which is currently supporting my research effort.”
2016 Career Development Award Project
Title of Project: Bone Turnover and Osteoporotic Fractures in Systemic Lupus Erythematosus
Project Summary: Osteoporosis is an insidious and often devastating complication of SLE. However, little is known about recent osteoporotic fracture rates in SLE patients or the real-world effects of glucocorticoids (GC) and lupus nephritis on fracture risk. Furthermore, while vitamin D deficiency is common in SLE, vitamin D supplementation’s effect on bone turnover in SLE is unknown.
Among racially-diverse U.S. Medicaid enrollees, 2000-2010, we have identified >57,000 SLE patients (22% with nephritis). Incident osteoporotic fractures of the hip, wrist, humerus and pelvis will be identified. We will calculate fracture incidence rates and rate ratios in SLE and non-SLE patients, in subgroups by age, race and nephritis, and investigate the effects of GC dose.
Among SLE patients, we will test if fracture rates have declined and investigate prescriptions of GC, bisphosphonates, and vitamin D from 2000-2010.These analyses will be complemented by a study leveraging data from a randomized controlled trial of vitamin D vs. placebo in racially-diverse SLE subjects.
Using blood samples from trial baseline and end, we will assay the bone turnover markers C-terminal telopeptide of type I collagen and procollagen type I N-terminal propeptide. This trial will allow us to test if vitamin D repletion decreases bone turnover in SLE subjects, critical knowledge for combatting osteoporosis in SLE. Multivariable linear regression models will evaluate the effect of vitamin D vs. placebo on changes in bone turnover markers.
The proposed studies will be the centerpiece of Dr. Sara Tedeschi’s comprehensive research training program at Brigham and Women’s Hospital Lupus Center. She has assembled a multidisciplinary team of seasoned mentors and scientific advisors and will attend classes and national conferences. Her results will provide crucial data for osteoporosis prevention strategies in SLE and will position her extremely well for continued career development as a dedicated lupus clinical researcher.
Publications Resulted from CDA Award:
Tedeschi SK, Aranow C, Kamen DL, LeBoff M, Diamond B, Costenbader KH. Effect of vitamin D on serum markers of bone turnover in SLE in a randomized controlled trial. Lupus Sci Med. 2019 Sep 17;6(1):e000352. doi: 10.1136/lupus-2019-000352.
Tedeschi SK, Kim SC, Guan H, Grossman JM, Costenbader KH. Comparative fracture risks among US Medicaid enrollees with and without systemic lupus erythematosus. Arthritis Rheumatol. 2019;71(7):1141-1146.