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Dr. Nazleen Khan’s passion for pharmacoepidemiology began as a public health major at the University of Maryland. Upon exposure to the transformative impact that a career in drug safety research can have on the world, Khan pursued a PhD in the field and developed an interest in drug interactions along the way. Now a T-32 postdoctoral fellow, Khan’s research bridges two areas of concern—arthritis, a disease that results in lifestyle and economic burdens for many Americans, and opioid medication use. In this blog post, Dr. Khan discusses the early influences that led her to pharmacoepidemiology, her research interests, and the importance of collaboration in research.
The Road to OrACORe
Dr. Khan was introduced to the field of pharmacoepidemiology through a case study on the anti-nausea drug, Thalidomide. In the 1950s and ‘60s, thalidomide was offered in many European countries to pregnant women experiencing morning sickness. The use of this drug in pregnant women resulted in severe birth defects in their children. The thalidomide controversy exemplified to Khan how critical large-scale drug safety research is and motivated her to pursue a career in pharmacoepidemiology. After graduating from the University of Maryland, Khan relocated to Boston to become a research assistant with the Brigham and Women’s Hospital Division of Pharmacoepidemiology and Pharmacoeconomics. There, she used large administrative claims databases to answer questions about comparative safety and the effectiveness of prescription medications in a range of clinical areas. “Being under the guidance of leaders in the field was a wonderful experience. The research environment encouraged me to continue learning and developing a deeper understanding of this unique realm of public health,” said Khan. After completing her research assistantship, Khan continued her studies at the Harvard T.H. Chan School of Public Health, where she earned a master’s degree and PhD in pharmacoepidemiology. Throughout her time at Harvard, she focused her research questions on pain management, eventually writing her dissertation on the risk factors for opioid overdose, a topic of great importance in the context of the ongoing opioid epidemic.
A Bridging of Interests
As Khan conducted research for her doctoral dissertation, she identified an interesting pattern in her research population. “My research included individuals who used opioids for pain management for at least 3 months, and I noticed that a large subset of this population suffered from osteoarthritis (OA) or rheumatoid arthritis (RA). I was immediately interested in better understanding these patients, but I was unfamiliar with arthritis and the different perspectives of experts in the field,” Khan explained. This interest in the OA and RA patient cohorts led Khan to search for research opportunities that offered the expertise and resources she’d need to begin her investigation on opioid medication use and arthritis. “When I learned about the T-32 fellowship, I was thrilled by the opportunity to apply as a post-doctoral fellow with the OrACORe team. The group’s research is at the intersection of osteoarthritis and pain research, and with Dr. Katz’s background as a rheumatologist, I also knew that I would have a complete set of resources to guide me in formulating my research questions on two different types of arthritis.”
Upon joining OrACORe as a T-32 post-doctoral fellow, Khan began her investigation on drug-drug interactions in a cohort of individuals with OA and RA who were prescribed opioids to manage their pain. “Patients may be taking multiple medications to address their pain, so I’m interested in learning whether these medications interact with each other to increase the risk of adverse events, such as fall or fracture. If so, I’m even more curious about the implication of potential drug-drug interactions on the patients’ functional status.” Khan’s research casts a spotlight on an area with limited available literature and in the national context of the opioid epidemic. “There are few studies that investigate the impact of drug-drug interactions, particularly with opioids, on the arthritis community. Given how common and incredibly burdensome these diseases are, I feel motivated to continue asking questions that might progress our understanding of pain management strategies in this patient population. I hope my work provides meaningful recommendations to physicians, and their patients, on treatments that are safe and effective.”
There are few studies that investigate the impact of drug-drug interactions, particularly with opioids, on the arthritis community…I hope my work provides meaningful recommendations to physicians, and their patients, on treatments that are safe and effective.Dr. Nazleen Khan
Khan points to the importance of collaborating with mentors for framing novel questions. “Drs. Seoyoung Kim and [Jeffrey] Katz have been instrumental in shaping how I approach my research. They’ve provided fresh perspectives informed by the interactions they’ve had with their patients as rheumatologists, so I appreciate how generous they’ve been with their time. “
A Path Forward
Khan looks at her future in academia with excitement. “Studying pain management has been my longstanding passion ever since I learned about Thalidomide in my undergraduate epidemiology course. I’m looking forward to asking new questions and providing information that can be used to improve patient safety. Collaboration and research are intimately tied, so I know I’ll have countless opportunities to work alongside some wonderful colleagues whose missions align with mine.”
Advice for future researchers
For those interested in a career in research, Khan offers some invaluable advice— “It’s so important to position yourself in environments where you can gain exposure to the different clinical areas around you. Do this especially if you are interested in health care research because you’ll be surrounded by rich sources of knowledge. Challenge yourself by getting involved in new projects and be open to learning from your team! I did all of these things and ultimately landed in a career that I am deeply passionate about.”
Challenge yourself by getting involved in new projects and be open to learning from your team! I did all of these things and ultimately landed in a career that I am deeply passionate aboutDr. Nazleen Khan