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Lupus Program

Systemic Lupus Erythematosus (SLE, or lupus) is autoimmune disease in which the immune system causes inflammation in the joints, skin, kidneys, lungs, and other internal organs. Rheumatologists are experts in the care and treatment of patients with lupus, and at the Yale Lupus Program, they also coordinate care with other specialists to provide comprehensive evaluation and treatment plans. Clinical and basic science researchers at the Yale School of Medicine are also part of the Program, with the goals to advance the treatment and understanding of this complex disease. The Program thus provides unparalleled access to experts in the patient care, assessment of disease activity using up-to-date clinical measurements, and treatment and the most up-to-date information about new therapies and research findings.

The clinical program is directed by Fotios Koumpouras, MD, who also is the principal investigator of the Biorepository of the Section of Rheumatology, Allergy and Immunology at Yale. Multiple other rheumatologists and other specialties are integral members of the program and see lupus patients in the clinic. Faculty directing research programs in lupus include Drs. Richard Bucala, Joseph Craft,Insoo Kang, Mark Mamula, Eric Meffre, and Andrew Wang.


Clinical Care

The Yale Lupus Program provides comprehensive evaluation and treatment of patients at the Yale St. Raphael’s Campus and the Interventional Immunology Center at North Haven, as well as education about the disease for patients and their family members. Patients are evaluated and treated by rheumatologists and other specialists, including dermatologists and nephrologists. The Program provides multidisciplinary evaluations by experts in maternal-fetal medicine, neurology, pulmonary medicine, and cardiology. The Program also contains:

  • A state-of-the art Infusion Center for administration of the most up-to-date therapies.
  • A Lupus Wellness Program to help patients and their families understand the complexity of lupus, as education is the first step in empowering patients to be an active part of their treatment decisions and improve their quality of life.
  • A Transition Program enabling adolescents understand lupus and become involved in their treatment, while working towards each patient's goals emphasizing education and shared decision making.

Research

An essential part of the Yale Lupus Program is ongoing clinical and translational research, with the goal to better understand the causes of lupus, and to advance treatment. Patients cared for at Yale have access to novel therapies and the opportunity to participate in clinical research studies should they so choose.

Goals and Impact

Goals
  • Deliver patient-centered care for SLE by a team of dedicated experts
  • Participate in treatment programs offered at Yale and by the Lupus Clinical Investigators Network (LuCIN), comprised of the best academic centers in the United States and Canada
  • Voluntarily participate in research studies at Yale designed to enhance understanding of the causes and treatment of lupus


Impact

  • Regional hub for patient care and access to novel treatments for lupus
  • Member site of the North American Lupus Clinical Investigators Network (LuCIN)
  • Member of the team that studied the novel use of voclosporin (LUPKYNSTM), leading to approval by the Food and Drug Administration for treatment of lupus nephritis
  • Provision of expertise to the Lupus Foundation of America and the Lupus Research Alliance
  • Development of the first rheumatology-dermatology clinic in Connecticut
  • First ever clinical trials program for SLE at Yale
  • Development of clinical specimen biorepository for SLE to supporting research into understanding and treating lupus

Lupus Wellness Program

The Yale Lupus Program offers a comprehensive Lupus Wellness Program that provides lupus patients with knowledge about their disease and methods and means to manage multiple aspects of their health. Meeting in one-on-one sessions with a nurse practitioner, patients learn about their disease and how to recognize and manage lupus symptoms. Lupus patients are also taught how to improve self-advocacy and adherence. The Lupus Wellness Program empowers patients with tools to help maximize communication with their health care providers and to use technology to maintain their personal health records. The program also hosts support group meetings throughout the year where participants meet other people with lupus, and together learn about nutrition, exercise, and stress reduction techniques. The Lupus Wellness Program is an especially important resource for those newly diagnosed with lupus or those who are transitioning from pediatric rheumatology practice into the adult rheumatology setting. The program is also offered in Spanish.

To learn more or to make an appointment with nurse practitioner Jacinta Renaldi, RNP

Program Leader

  • Associate Professor of Clinical Medicine (Rheumatology); Director of Education and Training, Rheumatology; Director Yale Lupus Program

    Dr. Fotios Koumpouras is Assistant Professor of Medicine and Director of the Yale Lupus Program. Dr. Koumpouras is a native of New York City and is a graduate of the Stuyvesant School at 16yrs of age. He completed his college education at State University of New York with honors in Chemistry and Biology, and was a member of the research team at the Wadsworth Center New York State Department of Health investigating cyclin E as a prognostic marker for breast cancer. In addition, he was part of the effort at the Albany Medical College to bio-engineer erythrocytes in search for a new blood substitute. Dr. Koumpouras attended St. George's University School of Medicine and was elected into Iota Epsilon Alpha, the international medical honor society, and graduated first in his class, completed post-graduate training in internal medicine and was Chief Medical Resident at Stony Brook University. He completed a clinical rheumatology fellowship program, as well as a program in Investigative Rheumatology, at Yale University School of Medicine. He was awarded the Physician Scientist Development Award from the American College of Rheumatology, and was co-PI for the ILAR project geared to improve access for rheumatologic services in East Africa. Dr. Koumpouras worked closely with Dr. Susan Manzi from 2007-2015 at the University of Pittsburgh and Allegheny Clinic, and was an integral member of the clinical research team. He was involved in both investigator initiated and pharmaceutical clinical trials for SLE and was principal site investigator for the ITN trial of Abatacept and Cyclophosphamide for Lupus Nephritis. He was also principal site investigator for the Double-Blind Randomized Placebo-Controlled Trial of the Effect of Vitamin D3 on the Interferon Signature in Patients with Systemic Lupus Erythematosus. Furthermore, he was site co-PI for the SLICC clinical research program, which resulted in improved criteria for the diagnostic assessment of SLE. He was co-investigator of the Safety and Effectiveness of Belimumab in Systemic Lupus Erythematosus Registry (SABLE) clinical trial. Dr. Koumpouras was the site PI for BLISS 99 and co-PI for HGS 1006, the clinical trials that lead to approval of Benlysta for the treatment of systemic lupus.  Presently Dr. Koumpouras is the principle investigator for several active clinical trials in SLE at Yale and developed and is principle investigator of the Yale Rheumatology BioRepository.Dr. Koumpouras is board certified in both internal medicine and rheumatology. He is an active member of the American College of Rheumatology, the Arthritis Foundation, and the Lupus Foundation.  He is an committee member for the ACR RheumPAC, often going to Washington to advocate for arthritis in congress.  In addition to SLE, Dr. Koumpouras has an interest in lupus biomarkers, new lupus therapeutics, clinical trial management and execution, rheumatology education, diagnostic and treatment dilemmas, and adolescent arthritis.

Our Team

  • Waldemar Von Zedtwitz Professor of Medicine (Rheumatology) and Professor of Pathology and of Epidemiology (Microbial Diseases); Chief, Rheumatology, Allergy, & Immunology; Rheumatologist in Chief, Rheumatology; Affiliated Faculty, Yale Institute for Global Health

    Richard Bucala, MD, PhD, is a Professor of Medicine, Pathology, and Epidemiology & Public Health.  He studies the mechanisms by which protective immune responses lead to immunopathology, focusing on MIF-family cytokines and their genetics, which his group first cloned and characterized experimentally.  Currently, his laboratory is leading multidisciplinary efforts to develop immunotherapies tailored to an individual’s genetic makeup. An anti-MIF antibody developed by the group is undergoing clinical testing in oncology, and an anti-MIF receptor antibody, recently FDA approved, is under evaluation in SLE. Dr. Bucala also is credited with the discovery of the fibrocyte, which is being targeted therapeutically in different fibrosing disorders.  He is a co-founder of Cytokine Networks and of MIFCOR, a biotechnology startup begun as a student-advised project.  Dr. Bucala was elected to the American Society for Clinical Investigation and the Association of American Physicians. He is the Editor-in-Chief of Arthritis & Rheumatology and has served on numerous advisory boards for the NIH, the pharmaceutical industry, academia, and private foundations.
  • Assistant Professor of Medicine (Rheumatology, Allergy & immunology)

    Dr. Chock completed her MD degree at Dalhousie University in Nova Scotia, Canada.  She completed her residency at New York Presbyterian in Queens, New York.  Dr. Chock joined the Section of Rheumatology for her fellowship in 2016, she recently received her MPH degree from Johns Hopkins University. She has a strong interest in data synthesis, systematic reviews and meta- analysis. Her current research endeavor includes investigation of drug effects and outcomes using large health survey or administrative data.
  • Paul B. Beeson Professor of Medicine (Rheumatology) and Professor of Immunobiology; Paul B. Beeson Professor of Medicine; Program Director, Investigative Medicine

    Dr. Joe Craft, Paul B. Beeson Professor of Medicine and Professor of Immunobiology at Yale, is a graduate of the University of North Carolina School of Medicine. He did postgraduate training in internal medicine, rheumatology and immunology at Yale, and directs a laboratory devoted to understanding of systemic lupus erythematosus (SLE, lupus) and host responses to viral pathogens. Dr. Craft is a two-time NIH MERIT Awardee, recipient of the Yale Bohmfalk Basic Science Teaching Prize, and an elected Fellow of American Association for Advancement of Science. He directs the Yale Investigative Medicine MD to PhD Program and is Director of the Colton Center for Autoimmunity at Yale. Dr. Craft is chair of the Board of Lupus Therapeutics of the Lupus Research Alliance (LRA), past chair of the Board of Scientific Counselors at NIAMS and of the Scientific Advisory Board of the Alliance for Lupus Research (now LRA). He chaired the Immunological Sciences (now Hypersensitivity, Autoimmune and Immune-mediated Diseases) Study Section of NIH and is a former Pew Scholar in the Biomedical Sciences and a Kirkland Scholar. He is co-founder of L2Diagnostics, a company in New Haven, CT, formed in partnership with Yale University and devoted to discovery of new diagnostics and therapeutic targets for immunological and infectious diseases, and is currently a member of its Board of Directors.
  • Assistant Professor

    Dr. Dong received medical degree from Wuhan University School of Medicine before pursuing PhD study at University of Connecticut Health Center. Her PhD work focused on chemoattractant signaling in leukocyte homing and activation at sites of infection and inflammation including atherosclerosis. After PhD, she joined Dr. Joseph Craft’s laboratory at Yale for postdoctoral training. She studied transcriptional factors in immune cell development in murine lupus under the auspices of postdoctoral Brown-Coxe Fellowship and Arthritis Foundation Postdoctoral Fellowship. During rheumatology fellowship training at Yale, she investigated the role of STAT4-guided pathogenic cytokine production in human lupus. Her current research is to understand cardiovascular diseases in systemic lupus erythematosus.
  • Professor; Director of Allergy & Immunology, Internal Medicine

    Dr. Insoo Kang is Professor of Medicine (Rheumatology, Allergy & Immunology) at Yale University School of Medicine. He completed his post-graduate training in rheumatology and immunology research at Yale. He has been on the faculty at Yale School of Medicine since 1999. He is a physician scientist with a research interest in understanding the human immune system using biological samples and clinical data. In particular, Dr. Kang has defined subsets of T cells with distinct cellular characteristics based on the expression of cytokine receptors on T cells in health and disease as well as the interactions of such cell subsets with monocytes and other immune cells.
  • Associate Professor of Clinical Medicine (Rheumatology); Director of Education and Training, Rheumatology; Director Yale Lupus Program

    Dr. Fotios Koumpouras is Assistant Professor of Medicine and Director of the Yale Lupus Program. Dr. Koumpouras is a native of New York City and is a graduate of the Stuyvesant School at 16yrs of age. He completed his college education at State University of New York with honors in Chemistry and Biology, and was a member of the research team at the Wadsworth Center New York State Department of Health investigating cyclin E as a prognostic marker for breast cancer. In addition, he was part of the effort at the Albany Medical College to bio-engineer erythrocytes in search for a new blood substitute. Dr. Koumpouras attended St. George's University School of Medicine and was elected into Iota Epsilon Alpha, the international medical honor society, and graduated first in his class, completed post-graduate training in internal medicine and was Chief Medical Resident at Stony Brook University. He completed a clinical rheumatology fellowship program, as well as a program in Investigative Rheumatology, at Yale University School of Medicine. He was awarded the Physician Scientist Development Award from the American College of Rheumatology, and was co-PI for the ILAR project geared to improve access for rheumatologic services in East Africa. Dr. Koumpouras worked closely with Dr. Susan Manzi from 2007-2015 at the University of Pittsburgh and Allegheny Clinic, and was an integral member of the clinical research team. He was involved in both investigator initiated and pharmaceutical clinical trials for SLE and was principal site investigator for the ITN trial of Abatacept and Cyclophosphamide for Lupus Nephritis. He was also principal site investigator for the Double-Blind Randomized Placebo-Controlled Trial of the Effect of Vitamin D3 on the Interferon Signature in Patients with Systemic Lupus Erythematosus. Furthermore, he was site co-PI for the SLICC clinical research program, which resulted in improved criteria for the diagnostic assessment of SLE. He was co-investigator of the Safety and Effectiveness of Belimumab in Systemic Lupus Erythematosus Registry (SABLE) clinical trial. Dr. Koumpouras was the site PI for BLISS 99 and co-PI for HGS 1006, the clinical trials that lead to approval of Benlysta for the treatment of systemic lupus.  Presently Dr. Koumpouras is the principle investigator for several active clinical trials in SLE at Yale and developed and is principle investigator of the Yale Rheumatology BioRepository.Dr. Koumpouras is board certified in both internal medicine and rheumatology. He is an active member of the American College of Rheumatology, the Arthritis Foundation, and the Lupus Foundation.  He is an committee member for the ACR RheumPAC, often going to Washington to advocate for arthritis in congress.  In addition to SLE, Dr. Koumpouras has an interest in lupus biomarkers, new lupus therapeutics, clinical trial management and execution, rheumatology education, diagnostic and treatment dilemmas, and adolescent arthritis.
  • Associate Professor of Medicine; Associate Program Director - Nephrology Fellowship, Nephrology

    Dr. Luciano has expertise in treating patients with glomerular disease (a kind of kidney disease that affects the filtering aspect of the kidney) and kidney-related vasculitis. Additionally, Dr. Luciano treats patients with, but not limited to, minimal change disease, membranous nephropathy, FSGS, renal amyloidosis, Lupus nephritis, IgA nephropathy, and ANCA mediated vasculitis. He is directly involved in the diagnosis (through biopsy) and treatment of patients with glomerular disease. In addition, he coordinates several clinical trials to help further progress the treatment options for these diseases.
  • Staff Affiliate - YNHH; Family Nurse Practitioner

    "Be kind, for everyone you meet is fighting a battle you know nothing about.". Jacinta Renaldi MSN is a board certified Family Nurse Practitioner working in the section of Rheumatology at Yale. Beginning her career in nursing in 2004, Jacinta has worked with diverse populations ranging from newborns to geriatric patients in a variety of settings. She began practicing rheumatology in 2009 and joined Yale Rheumatology in 2015. She has a special interest in the treatment of Lupus and other Connective Tissue Disorders and has worked extensively in the development of the Yale Lupus Wellness Program. Jacinta is also a key member in the section of Rheumatology’s Transition of Care Program for young adults with rheumatic disease.
  • Associate Research Scientist

    Dr. Seth obtained his BA and MA from Harvard University in 1998 and began his MD/PhD training at Rockefeller-Cornell before transferring with his research mentor to complete his degrees at University of Texas Southwestern in 2007. He came to Yale for residency in Internal Medicine and joined the Section of rheumatology for his fellowship in 2010. Dr. Seth has considerable success in his training years including Thomas Temple Hoope’s Prize for best undergraduate thesis at Harvard, and a patent from his Master’s work, with publication of 6 manuscripts, including a first author paper in the top-ranked Journal of Cell Biology on actin assembly. Dr. Seth received numerous undergraduate and graduate research fellowships and was the recipient of an ACR REF Scientist Development Award in 2013, with funding through 2016. He has been mentored by Dr. Craft as he hones his skills in genetic analysis of cell development, and function of Tfh cells in immunity and autoimmunity.
  • Associate Professor Term; Chief, Division of Pediatric and Adolescent Gynecology, Department of Obstetrics, Gynecology and Reproductive Sciences

    Yale gynecologist Dr. Alla V. Vash-Margita focuses her practice on the medical and emotional needs of children and adolescent girls. It’s a subspecialty, she notes, that represents “a grey zone, where pediatricians may not have enough expertise and ‘adult’ gynecologists may be out of their comfort zone.”As an assistant professor in the department of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine, Dr. Vash-Margita also teaches medical and midwifery students how to care for women of all ages. “I take great pride in working in close collaboration with a group of excellent students and midwives,” says Dr. Vash-Margita. “We care for women ages 11 to 90.”Dr. Vash-Margita’s clinical interests include office hysteroscopy and office saline hysterograms, abnormal Pap tests, female pelvic pain, gynecological laparoscopy, breech vaginal deliveries, TOLAC (trial of labor after cesarean section) and forceps-assisted deliveries.Dr. Vash-Margita received her MD from Uzhgorod State University Medical School in Ukraine and went on to complete her Ob/Gyn residency at Mount Sinai Medical Center in New York. Dr. Vash-Margita speaks seven languages (English, Ukrainian, Slovak, Polish, Russian, Serbian, and Hungarian). Her fluency in multiple languages allows her to be an active contributor to numerous global humanitarian organizations, including the United Ukrainian American Relief Committee and Yale’s Post Traumatic Stress Disorder Education Program, which provided psychological counseling to victims of the 2014 Ukraine Revolution.

For Referring Physicians

New patients are seen on a referral basis only using the new patient referral form which should be faxed to 203-785-7053 or for patients who are currently seen within the Yale New Haven Health and its partner organizations, a referral must be entered into EPIC by choosing the YNH Arthritis & Rheumatology option.