John M. Davis III, M.D., M.S., studies ways to improve the clinical assessment of patients with rheumatoid arthritis (RA) using a variety of approaches. His research spans epidemiologic population-based studies, patient-oriented translational research and clinical trials. As a clinical translational researcher, Dr. Davis collaborates with other physicians and scientists toward an improved understanding of many facets of rheumatoid disease and the development of improved approaches for individualizing the clinical assessment and decision-making for patients with RA.
- Patient-physician discordance. Patients often judge their diseases to be more severe or active than their rheumatologists do. Using a patient-centered, mixed quantitative and qualitative approach, Dr. Davis is investigating many factors that may potentially contribute to this discord, with the goal of developing clinical tools that improve not only measurement of disease activity but also communication between patients and physicians, and hence lead to better concordance of disease assessment.
- Pain research. Pain is the cardinal symptom of rheumatoid arthritis. Unfortunately, pain commonly persists despite current treatment strategies. Dr. Davis and his colleagues are using functional magnetic resonance imaging to investigate the mechanisms of pain persistence among patients with RA and the dynamics between pain and the immune system.
- Cardiovascular disease. Cardiovascular morbidity and mortality are dramatically increased in patients with RA. Dr. Davis collaborates on research seeking to understand the disease biology of heart failure in patients with RA and to develop clinical methods of identifying patients at risk in whom preventive strategies could be initiated. This research involves echocardiographic studies and immune biomarker profiling. Additionally, Dr. Davis is involved with research focusing on improving routine cardiovascular risk assessment through a joint cardiology-rheumatology clinic.
- Individualized immune response signatures. Dr. Davis collaborates with immunologists to develop new immune biomarkers for predicting disease outcomes and response to drug treatments. He and his colleagues have devised novel approaches of stimulating human immune cells in the test tube and measuring their functional responses in terms of either cytokine protein production or immune gene expression. Recent work has focused on a T cell response to human cytomegalovirus as predictive of inadequate treatment response and joint damage.
- Clinical trials. Dr. Davis is an investigator of multiple investigator-initiated or industry-sponsored clinical trials of novel therapeutic agents for RA.
Significance to patient care
Dr. Davis anticipates that through his research activities he will advance new clinical tools and approaches to improve care for patients with RA. By improving the ability of rheumatologists to measure the impact of the disease on their patients and to understand mechanisms of adverse health despite treatment, he anticipates new treatment strategies that alleviate patient pain, improve physical and mental functioning and quality of life, and restore satisfaction with health care. He expects the eventual development of new imaging and immune biomarkers that enable early detection of cardiovascular disease and the initiation of strategies to prevent heart involvement.
- Research chair, Division of Rheumatology, Mayo Clinic, 2011-present