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Jeffrey A. Sparks, MD, MMSc
Associate Physician, Brigham and Women's Hospital
Assistant Professor of Medicine, Harvard Medical School

Brigham and Women's Hospital
Department of Medicine
Rheumatology, Immunology and Allergy
75 Francis Street
Boston, MA 02115

Research Email: JASPARKS@PARTNERS.ORG



Research Narrative:

Dr. Sparks is a rheumatologist and population scientist with an overall focus on using patient-oriented and epidemiologic research studies to evaluate the etiology, outcomes, and public health burden of rheumatic diseases such as rheumatoid arthritis (RA). In particular, he performs studies to evaluate the genetic, environmental, serologic, and familial risk factors for RA, clinical trials for RA prevention, RA outcomes research focusing on the respiratory burden of RA, evaluates metabolic factors such as weight loss for RA outcomes, and investigates rheumatic manifestations of osseous sarcoidosis. He uses large population-based studies for these studies, including the Nurses’ Health Studies, the Studies for the Etiology of RA, the Partners electronic medical record, the Brigham RA Sequential Study, and pharmacy claims databases. He also performs clinical trials including the Personalized Risk Estimator for RA (PRE-RA) Family Study, the Strategy to Prevent the Onset of Clinically-Apparent RA (StopRA), and the Cardiovascular Inflammation Reduction Trial (CIRT).

Genetic, environmental, serologic, and familial risk factors for RA: Dr. Sparks and colleagues perform studies to investigate the etiology of rheumatoid arthritis. Many studies of these studies are performed in the Nurses’ Health Studies (NHS), two cohorts composed of nearly 250,000 women who have been followed for up to 40 years. Detailed questionnaires gather data on lifestyles, diet, medications, physical activity, and medical history. He and his team validate incident rheumatic diseases including rheumatoid arthritis (RA) and lupus. A subset of women donated samples on which studies on genetics and other biomarkers for RA susceptibility and outcomes are performed. Other investigations examine risk factors for inflammatory joint signs among unaffected RA relatives in the Studies of the Etiology of RA, a multicenter prospective cohort in the US. Current interests include omega-3 fatty acid, fish intake, sleep duration, nightshift work, pre-diagnostic metabolomic profiling, and gene-environment interactions for risk of developing RA.

Clinical trials for RA prevention: Dr. Elizabeth Karlson and Dr. Sparks are using personalized RA risk information as an intervention in a randomized controlled trial of unaffected first-degree relatives of RA patients, the Personalized Risk Estimator for RA (PRE-RA) Family Study. This study evaluates whether personalized RA risk education affects willingness to change RA-related behaviors. The RA risk calculator in PRE-RA was based on validated RA risk models from previous work. Other analyses of interest include risk perception, RA knowledge changes, healthcare utilization, and long-term follow-up for RA risk. In addition, Dr. Sparks is the site PI for a double-blinded clinical trial randomizing high-risk subjects to hydroxychloroquine or placebo for the prevention of RA in the Strategy to Prevent the Onset of Clinically-Apparent RA (StopRA) trial funded by the NIH, which is currently recruiting patients who are at high risk of RA due to CCP-positivity.

RA outcomes research: Dr. Sparks and his team evaluated RA and risk of mortality during follow-up for women diagnosed with RA during the NHS. RA increased mortality risk by 40%, and respiratory mortality was nearly three-fold higher for women with seropositive RA even after adjusting for smoking. He also reported that smoking cessation at RA diagnosis lowers mortality risk. He is PI on a project funded by the Rheumatology Research Foundation that used advanced bioinformatics to create an RA cohort from the electronic medical record (EMR). He used a bioinformatics method to automatically extract clinical concepts from both structured and unstructured (typed, dictated, scanned) data in the EMR. Among nearly 10,000 patients identified with RA, nearly 45 million concepts were extracted from >500,000 documents. This is a rich dataset for outcomes research; he and his team are currently evaluating risk factors for pneumonia and subsequent outcomes. He has also performed advanced bioinformatics including phenome-wide association study for anti-citrullinated protein antibodies. Finally, he is funded by the NIH to use the NHS and Brigham RA Sequential Study (BRASS) to evaluate the effect of RA, autoantibodies, and inflammatory markers on respiratory outcomes such as obstructive lung disease, respiratory mortality, dyspnea, spirometry, and chest imaging.

Metabolic factors for RA etiology and outcomes: His group reported that overweight and obesity increased RA risk in the NHS. In the NHS, current interests include investigating the effect of dietary factors on RA risk, including soda consumption and dietary patterns and whether weight change at RA diagnosis influences mortality risk. In the EMR and BRASS, he is investigating whether weight change is associated with RA disease activity changes.

Rheumatic manifestations of sarcoidosis: Dr. Sparks performs studies on patients with rheumatic manifestations of sarcoidosis, in particular patients with osseous sarcoidosis. He reported that patients with osseous sarcoidosis are more likely to be asymptomatic and to have axial involvement. Current studies include imaging characteristics of osseous sarcoidosis and longitudinal outcomes of patients with osseous sarcoidosis.


Education:
Harvard Medical School, 2014, MMSc
University of Arkansas for Medical Sciences, 2007, MD
University of Arkansas, 2003, BS

Honors/Awards:
American College of Rheumatology, Distinguished Fellow Award
Rheumatology Research Foundation, Scientist Development Award
NIH, Career Development Award
NIH, Loan Repayment Award