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Home - Science - Scientist Directory - Merrill, Joan T.

Joan T. Merrill, M.D.

Member
Arthritis & Clinical Immunology Research Program

OMRF Professor of Medicine, University of Oklahoma Health Sciences Center

Adjunct Professor, School of Pharmacy, University of Oklahoma Health Sciences Center

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My 101

Lupus is a chronic autoimmune disease that can cause unpredictable flares of inflammation affecting almost any organ in the body. Although this illness can be relatively mild in many people, in others it can become quite severe or even life threatening, causing serious damage to the kidneys, heart, brain or lungs.

In my lab, we view lupus as an imbalance of the immune system rather than the immune system as some kind of enemy to a lupus patient. It’s there to defend us, not to attack us, but somehow, in lupus, it has become overactive in its defense, leading to excessive inflammation and collateral damage to the body.

The medicines used for lupus now work to suppress the immune system. But they also have unacceptable side effects and can impair the ability of the immune system to keep a person healthy, leading to serious infections and other unwanted consequences.

Instead, we’re looking for treatments that restore the balance of the immune system, such as new “biologic” treatments that can drill down and target even the tiny, individual proteins of the immune system, restoring its proper balance.

At OMRF, we run the Oklahoma Lupus Cohort—a group of more than 400 people with lupus who donate blood samples and clinical information for laboratory studies, so we can help develop new targeted treatments. We also do treatment studies for lupus patients who choose to participate in the testing of new biological agents. Some of the studies are very exciting, because they link laboratory studies with treatment assessments. Because people donate blood samples before, during and after the treatment, scientists can monitor the effects of the new treatments and learn more about the way the immune system actually works. And, because lupus is such a complicated disease, these studies may help to figure out which patients should be getting each specific treatment and what the best approach to dosing is.

Research

Heart attacks and strokes occur when fats slowly accumulate in blood vessels, causing breakdown of blood flow to arteries of the heart and brain. It is increasingly apparent that disorders in the regulation of inflammatory processes play a role in this accumulating process. Lupus is a disease characterized by flares of inflammation in the blood vessels, and lupus patients are at increased risk for premature atherosclerosis. The hypothesis underlying our work is that some of the specific disordered immune events that occur in lupus can shed light on the more low-grade inflammatory events that lead to progressive atherosclerosis in a wider, aging population.

Our research involves the study of variables that affect immune function and blood vessel regulation.  We have three projects that follow patients over time: a national registry of the antiphospholipid syndrome, the SLICC registry, which studies risk factors for premature atherosclerosis (we are one of 30 sites around the world participating in this collaborative study), and basic research linked to pharmaceutical-sponsored clinical trials of investigational drugs for lupus.

Our group also does basic research into the ways in which lupus immune proteins interfere with structures that help maintain a healthy bloodstream. This includes antiphospholipid antibodies (which interfere with the blood clotting system), antibodies to proteins that regulate cholesterol and antibodies to other blood vessel regulators such as platelets.

The Clinical Pharmacology team works with several international groups to distill the complexities of lupus down to manageable and testable targets for new immune-modulating treatments. These projects range from the testing of updated disease criteria and clinical outcome measures (working with the Systemic Lupus International Collaborating Clinics) to the validation of improved biologic tests for determining the safety and effectiveness of investigational drugs. We have also developed projects which link pharmaceutical-sponsored drug trials in lupus to basic laboratory research studies. We have completed a recent study called Biomarkers of Lupus Disease (BOLD) which demonstrates the complexities of performing clinical trials with multiple background treatments being used and characterizes the immune interference of each of the most commonly used background treatments in these trials. We are currently studying dipyridamole and abatacept in trials of lupus that are capitalizing on information we learned from the BOLD study, trying to simplify background treatments and avoid the “noise” that interferes with figuring out how treatments work.

Brief CV

Education
B.A., Vassar College, Poughkeepsie, NY, 1972
M.D., Cornell University Medical College, New York, NY, 1985

Honors and Awards
2000 Edmund Dubois Award, American College of Rheumatology
2006 Ira Goldstein Award and Lectureship, New York University Advance Course in Rheumatology

Other Activities
Chief Advisor for Clinical Development, Lupus Foundation of America 2016 - present
Medical Director, Lupus Foundation of America 2004-2016
Medical and Scientific Committee, National Arthritis Foundation 2000-2003
Research Committee and Clinical Research Subcommittee, American College of Rheumatology, 2002-2004
Chair, APLS Abst Subcommittee, American College of Rheumatology Meeting 1999-2002
Planning Committee, American College of Rheumatology Meeting, 1999-2002
American College of Rheumatology Sponsored Programs Committee 2001-2004
Vice-Chair, Medical and Scientific Committee, N.Y. Chapter Arthritis Foundation, 2000-2001

Memberships
American College of Rheumatology
New York Academy of Science
The Henry Kunkel Society (elected 1998)
Systemic Lupus International Collaborating Clinics (elected 1998)

Joined OMRF Scientific Staff in 2001.

Publications

View more publications

Recent Publications

Chew C, Reynolds JA, Lertratanakul A, Wu P, Urowitz M, Gladman DD, Fortin PR, Bae SC, Gordon C, Clarke AE, Bernatsky S, Hanly JG, Isenberg D, Rahman A, Sanchez-Guerrero J, Romero-Diaz J, Merrill J, Wallace D, Ginzler E, Khamashta M, Nived O, Jönsen A, Steinsson K, Manzi S, Kalunian K, Dooley MA, Petri M, Aranow C, van Vollenhoven R, Stoll T, Alarcón GS, Lim SS, Ruiz-Irastorza G, Peschken CA, Askanase AD, Kamen DL, İnanç M, Ramsey-Goldman R, Bruce IN. Lower vitamin D is associated with metabolic syndrome and insulin resistance in systemic lupus: data from an international inception cohort. Rheumatology (Oxford), 2021 February, PMID: 33555325

Wallace DJ, Isenberg DA, Morand EF, Vazquez-Mateo C, Kao AH, Aydemir A, Pudota K, Ona V, Aranow C, Merrill JT. Safety and clinical activity of atacicept in the long-term extension of the Phase IIb ADDRESS II study in systemic lupus erythematosus. Rheumatology (Oxford), 2021 February, PMID: 33547784

Isenberg DA, Kao AH, Aydemir A, Merrill JT. Commentary: Systematic Review of Safety and Efficacy of Atacicept in Treating Immune-Mediated Disorders. Front Immunol 11:592639, 2020 November, PMID: 33262771, PMCID: PMC7687657

Selected Publications

Langefeld CD, Ainsworth HC, Cunninghame Graham DS, ...Guthridge JM, Huggins  JL, James JA, ... Merrill JT, Miranda P, Moctezuma JF, Nath SK, ... Sivils KL, ... Alarcón-Riquelme ME, ..., Gaffney PM, Vyse TJ. Transancestral mapping and genetic load in systemic lupus erythematosus. Nat Commun. 2017 Jul 17;8:16021. PMID: 28714469 PMCID: PMC5520018

Kaplowitz ET, Ferguson S, Guerra M, Laskin CA, Buyon JP, Petri M, Lockshin MD, Sammaritano LR, Branch DW, Merrill JT, Katz P, Salmon JE. Socioeconomic Status Contributes to Racial/Ethnic Disparities in Adverse Pregnancy Outcomes among Women with Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). 2017 May 8. PMID: 28480528

Kim M, Merrill J, Kalunian K, Hahn B, Roach A, Izmirly P; Lupus Foundation of America Collective Data Analysis Initiative Group.. Brief Report: Longitudinal Patterns of Response to Standard of Care Therapy for Systemic Lupus Erythematosus: Implications for Clinical Trial Design. Arthritis Rheumatol. 2017 Apr;69(4):785-90. PMID: 27992696

Gerosa M, Poletti B, Pregnolato F, Castellino G, Lafronza A, Silani V, Riboldi P, Meroni PL, Merrill JT. Antiglutamate Receptor Antibodies and Cognitive Impairment in Primary Antiphospholipid Syndrome and Systemic Lupus Erythematosus. Front Immunol. 2016 Feb 1;7:5.  eCollection 2016. Review. PMID: 26870034 PMCID: PMC4740786

Renauer P, Coit P, Jeffries MA, Merrill JT, McCune WJ, Maksimowicz-McKinnon K, Sawalha AH. DNA methylation patterns in naive CD4+ T cells identify epigenetic susceptibility loci for malar rash and discoid rash in systemic lupus erythematosus. Lupus Sci Med 2:e000101, 2015. PMID: 26405558 PMCID: PMC4577980

* Zhao J, Wu H, Langefeld CD, ...James JA, Merrill JT, et al.  Genetic associations of leptin-related polymorphisms with systemic lupus erythematosus. Clin Immunol. 2015. 2015 Dec;161(2):157-62. PMID: 26385092 PMCID: PMC4658308

 

Contact

Clinical Pharmacology Research Program, MS 22
Oklahoma Medical Research Foundation
825 N.E. 13th Street
Oklahoma City, OK 73104

Phone: (405) 271-7805
Fax: (405) 271-3980
E-mail: Joan-Merrill@omrf.org

Lab Staff

Fredonna Carthen
Clinical Trials Project Administrator

Sheryl Delancy
Senior Clinical Research Nurse

Lydia Mitchell
Clinical Research Nurse

Stan Kamp
Senior Research Assistant

Jeff Turner
Clinical Research Technician

Stephen Apel
Programmer

Misty Mihelich
Patient Access Representative

News from the Merrill lab

Dr. Merrill in the Media

News from the Merrill lab

OMRF researcher honored by Lupus Foundation of America
February 15, 2021

The award recognizes Merrill’s exceptional contributions to the field in her nearly 30 years as a lupus physician and researcher.

Oklahoma doctors react to Trump’s announcement of taking hydroxychloroquine
May 19, 2020

Multiple studies have show the drug is not effective at treating COVID-19, and in some cases can even cause heart problems.

Doctor Cautions Enthusiasm For Possible Coronavirus Cure
March 24, 2020

OMRF’s Dr. Joan Merrill, who prescribes the malaria medication now being touted as a possible cure for coronavirus, is tempering enthusiasm for the drug.

Possible Coronavirus (COVID-19) Cure Has Patients Stockpiling
March 23, 2020

The president’s remarks about a medication being used now that could stop the coronavirus has sent some in the metro scrambling to their local pharmacy.

Run on drug for COVID-19 imperils lupus patients
March 23, 2020

The prospect that hydroxychloroquine might be effective for treating the coronavirus has raised hopes, but it’s also created a potential crisis.

OMRF findings could improve individualized lupus treatment options
September 16, 2019

The findings will help push clinicians closer to personalized medicine for lupus sufferers.

OMRF receives three grants to study autoimmune disease
November 12, 2018

The federal grants will support the work of two OMRF scientists who are investigating different aspects of autoimmune disease: Judith James, M.D., Ph.D., and Joan Merrill, M.D.

OMRF researcher honored by American College of Rheumatology
November 9, 2018

Joan Merrill, M.D., is a recipient of the 2018 ACR Master designation, one of the highest honors members can receive.

Experts propose improving clinical trials for lupus
April 23, 2018

The goal of the new white paper is to create a dramatic shift in how lupus clinical trials are conducted so effective treatments can stand a chance to succeed.

OMRF receives four grants totaling more than $5 million
August 8, 2017

The grants cover a range of areas, including colitis and colon cancer, sepsis, genomic tools, and outreach strategies for clinical trials.

International study reveals 24 new genes associated with lupus
July 19, 2017

These findings will help scientists understand how to better diagnose and treat the disease.

OMRF lupus researcher receives high honor
September 14, 2016

Joan Merrill was given a prestigious honor in Washington, D.C.

OMRF’s Merrill Named to New Role at the Lupus Foundation of America
March 15, 2016

The LFA has announced OMRF’s Merrill as its Chief Advisor for Clinical Development.

Don’t judge a disease by its cover
September 3, 2013

Autoimmune diseases affect millions, but the symptoms don’t always show.

New technology brings personalized lupus treatments one step closer
June 28, 2013

Understanding the effects of lupus drugs will lead to better outcomes for patients.

OMRF discovers three new lupus genes
March 29, 2012

The international study turns up new targets for lupus research

OMRF completes African-American lupus genetics study
September 14, 2011

A study from OMRF finds five genes linked to lupus.

Trial participants are unsung heroes of research
May 31, 2011

Patient volunteers like Phyllis Smith are vital to the drug trial process.

OMRF raises awareness with Lupus State Advocacy Day
May 4, 2011

Scientists emphasize the need for lupus funding and awareness.

FDA approves lupus drug
March 11, 2011

An OMRF-tested new lupus drug has gained FDA approval.

New lupus treatment shows promise
July 27, 2009

Researcher calls new drug “greatest thing in 50 years”

OMRF seeking patients for arthritis and lupus studies, drug trials
December 1, 2008

Researchers at OMRF are looking for rheumatoid arthritis and lupus patients to take part in studies of new treatments for the diseases. OMRF’s Clinical Pharmacology Research Program conducts pharmaceutical studies on rheumatoid arthritis and lupus. “We are in a unique position here at OMRF in that we are able to conduct clinical trials that are […]

OMRF seeks volunteers for rheumatoid arthritis studies
June 19, 2007

Scientists at the Oklahoma Medical Research Foundation are seeking rheumatoid arthritis patients to participate in one of several studies of new treatments for the disease. Rheumatoid arthritis is a chronic illness mainly characterized by inflammation of the lining of the joints. The symptoms include pain, swelling and stiffness in the joints and ultimately the disease […]

OMRF scientists present at International Congress on Lupus
May 29, 2007

A pair of physician-scientists from the Oklahoma Medical Research Foundation presented papers at the 8th annual International Congress on Lupus in Shanghai, China, last week. OMRF’s Joan Merrill, M.D., and John Harley, M.D., Ph.D., each gave invited presentations at the four-day conference, which focuses on the autoimmune disease lupus. More than 1,500 researchers, clinicians, scientists, […]

OMRF using smaller MRI to target hands, feet
September 19, 2006

Machine allows physicians to study effects of rheumatoid arthritis

OMRF’s Merrill Named Lupus Foundation of America’s First Medical Director
January 19, 2004

The Lupus Foundation of America (LFA) has named Oklahoma Medical Research Foundation scientist Joan Merrill, M.D., as the organization’s first Medical Director. Merrill will continue to serve as head of the Clinical Pharmacology Research Program at OMRF, one of the country’s leading centers for lupus research. Merrill received her undergraduate degree from Vassar College and […]

Dr. Merrill in the Media

Tulip-1 results fail to support phase 2 findings in lupus
MedWireNews.com

Zostavax proves safe, effective in nonactive SLE patients
MDEdge.com

Researchers gain better understanding of lupus
MuskogeePhoenix.com

Merrill on optimal entry criteria for lupus trials
Consultant360.com

OMRF's Merrill receives Master designation
JournalRecord.com

Disappointed but undaunted: Pursuing new avenues in lupus drug development
Healio.com

Exagen-patented biomarker linked to SLE disease activity
Healio.com

13 lupus researchers share $5 million for work advancing disease understanding and treatment
Lupusnewstoday.com

5 proposed solutions to FDA for optimizing clinical trials
ClinicalLeader.com

Experts propose improving clinical trials for lupus
NewsOk.com

Researchers propose improving clinical trials
JournalRecord.com

Blisibimod linked to steroid reduction, decreased proteinuria in patients with lupus
Healio.com

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