Research Projects

• An Early Cardiovascular Risk Marker: I was the first to show that subclinical arteriosclerosis identified on a kidney biopsy at Lupus Nephritis (LN) diagnosis is a reliable early marker of future cardiovascular disease (CVD).
• The First Evidence-based Practice Guidance on CVD Risk Prevention in LN: I led the first North American expert Delphi panel to deliver recommendations for CVD risk prevention in LN. This work will inform the development of an implementation toolkit to personalize CVD risk prevention based on a patient’s risk factors.
  
• Developing novel methods to develop a CVD preventive care bundle (risk assessment, monitoring, and preventive interventions).
  
• Leading multi-system cohorts & national databases (Epic Cosmos) to examine public health impact of CVD prevention

• Hydroxychloroquine (HCQ) Precision Dosing: I authored a highly-cited global meta-analysis establishing HCQ blood levels as an objective measure of adherence. Crucially, I defined the therapeutic reference range (750-1150 ng/ml) for HCQ in lupus, a finding adopted by national clinical laboratories (e.g., Exagen, labcorp), recognized with a 2025 ACR Plenary invitation, and now routinely being used in clinics.
• Target-Site Pharmacokinetics: I am pioneering novel work linking target-site pharmacokinetics and molecular profiling of SLE manifestations (e.g., cutaneous lupus, LN) to inform new drug development.
  
• Novel drug delivery and formulation discovery to advance precision dosing and guide personalized care based on an individual patient's clinical phenotype, risk factors, immune inflammatory signaling, and pharmacokinetics to improve outcomes.
  
• Novel Shared Decision-Making Tools: I led the development of HCQ-SAFE, the first interactive electronic shared decision-making tool. Its use improved adherence by 47% across eight clinics and has ensured better SLE disease control. This tool has been incorporated into the ACR's Lupus Implementation Guide, Lupus Initiative (LEAP), and Epic's turbocharger package. I pioneered the development of other tools such as PRED-Safe, and now developing a tool for comorbidity prevention in lupus nephritis and lupus.

• I founded one of the nation’s earliest multidisciplinary, one‑stop LN clinic at the University of Wisconsin, Madison. This clinic integrated nephrology, rheumatology, pathology, nursing, and pharmacy to streamline diagnostic evaluation, enhance coordination, and reduce time to treatment. This model has served as a template for multidisciplinary lupus programs nationally and directly informs my ongoing efforts to build expanded collaborative care structures at Yale.
• I have also contributed substantially to the development of national clinical practice guidelines for lupus and LN (Sammaritano
  et al. Arthritis Rheumatol. 2024 and 2025). I serve on multiple national committees, including the ACR Clinical Practice
  Guidelines Committee and the ACR Collaborative Care Initiative Committee, where I help shape strategic guidance on
  multidisciplinary care models and the development of pragmatic implementation tools. Collectively, this work has helped
  define scalable solutions to promote evidence‑driven care and implement innovative, patient‑centered models that improve
  health outcomes in lupus and other diseases.
  

Leading/Establishing Longitudinal Bio-Repositories and Data-Repositories with linked data, bio-specimens, pathology, images to enable a comprehensive understanding of drivers of outcomes in patients with lupus, early lupus, and/or incomplete lupus.