Garg Lupus Lab @ Yale

I am a physician-scientist in Rheumatology, Director of the Lupus Clinical Research Program and co-Director of the Lupus Program at Yale School of Medicine. My work advances personalized care and precision medicine by integrating target-site pharmacokinetics, interferon-driven immune signatures, and patient-centered qualitative methods to improve outcomes in lupus. Equally central to my program is the application of evidence-based medicine and implementation science to make precision actionable at the bedside.

My Plenary highlighted work at the 2019, 2020, and 2025 American College of Rheumatology (ACR) Annual Meetings has demonstrated that cardiovascular disease (CVD), risk aversion, and fear of toxicity related to fixed dosing are major drivers of poor outcomes in lupus, yet remain largely unaddressed in routine care. Therefore, my long-term goal is to leverage immunopharmacology and patient centric approaches to develop and implement personalized preventive interventions that improve health outcomes and survival in lupus nephritis, lupus, and other chronic diseases.

My research has delivered important contributions to the field:

1. The first study showing that subclinical arteriosclerosis on kidney biopsy at LN diagnosis is a reliable early marker of future clinical CVD events
2. A high-impact study, invited as a 2025 ACR Plenary presentation, defining a therapeutic reference range for hydroxychloroquine (HCQ) blood levels (750-1150 ng/mL) in lupus, advancing personalized dosing of HCQ; and
3. The first interactive, pictogram-based, end-user-informed, shared decision-making tools, HCQ-SAFE and Pred-SAFE, to clearly communicate the benefits and harms of HCQ and chronic prednisone use.

In summary, my research program is moving the science beyond “what happened” to understanding drivers ("how and why") of life-threatening events and poor clinical outcomes, and "what" improvements can be made (e.g., better drug delivery, integrating immune response with drug concentrations, targeted therapeutics, shared decision-making) to enable precise and personalized care for all people living with lupus, lupus nephritis, and other rheumatic (chronic) diseases.

Cumulatively, my work has led to earning a PhD, 3 national plenary presentations, 60+ publications, 1800+ citations, intramural and extramural funding (including prestigious NIH, Lupus Foundation of America, Rheumatology Research Foundation), multiple accolades, and shifting treatment paradigm (leading laboratories are using targeted drug level monitoring standards developed in my research program) in lupus by leveraging precision medicine and patient-centric approaches. I am the founding Director of Yale Lupus Clinical Research Program and co-Director of Yale Lupus Program. My strong commitment to patient-oriented research to improve survival in SLE, has led to the development of state-of-the-art clinics, bio-repositories, and a continuum of research and clinical care to deliver precise and personalized care at individual patient level.