Rheumatologist
Assistant professor in the Rheumatology department of the Medicine and Health Sciences Faculty of the University of Sherbrooke since 2006.
Associate professor in the Rheumatology department of the Medicine and Health Sciences Faculty of the University of Sherbrooke since 2014.
Training
Graduation and residency at the University of Sao Paulo, Brazil
Academic interests:
Continuous medical training targeted at the first line. Close collaborator with the Continuing Education Centre of FMSS in multiple rheumatology educational activities.
Research interests:
Scleroderma; close collaborator with the Canadian Scleroderma Research Group. The main research objectives relate to the treatment of problems common in scleroderma, such as malabsorption syndrome, faecal incontinence and digital ulcers.
Pulmonologist
Junior Scientist, RI-MUHC , Montreal General Hospital
Translational Research in Respiratory Diseases Program
Centre for Innovative Medicine
Assistant Professor, Department of Medicine, Faculty of Medicine, McGill University
Department of Medicine, Division of Respiratory Medicine, MUHC
My research focuses on interstitial lung diseases (ILD), a group of progressive, devastating lung diseases characterized by inflammation and scarring (fibrosis) of the lung tissue. The burden of disease is heavy: idiopathic pulmonary fibrosis, the most devastating form of ILD, has a median survival of only three to five years. The incidence and societal burden of ILD are increasing over time. Unfortunately, the right diagnosis is often initially missed or delayed, which will affect long term prognosis. Certain medications have been shown to slow the decline in lung function, but differences in treatment initiation can occur for reasons that remain largely unknown. My research program aims to identify discrepancies and delays in the care of patients with ILD from diagnosis to management, identify the risk factors for those delays, predict disease progression and explore the use of certain medications in understudied populations.
Selected Publications
Jean-Luc Senécal, MD, FRCPC, is a rheumatologist and member of the CHUM’s Rheumatology department. He holds the Scleroderma Research Chair at the University of Montreal.
Dr. Senécal specializes in the diagnosis and treatment of human systemic autoimmune diseases, such as scleroderma (systemic sclerosis), systemic lupus erythematosus and autoimmune myositis.
His fundamental research focuses on elucidating the pathophysiological mechanisms underlying these diseases and identifying new treatments.
Theme:
Immunopathogenesis and new therapeutic approaches to human systemic autoimmune diseases.
Research topics:
Dr. Marika Sarfati, MD, PhD, is Director of the Immunoregulation Laboratory at the CHUM Research Centre, and Full Professor, Department of Medicine, University of Montreal.
Chronic inflammatory skin diseases (psoriasis, atopic dermatitis, scleroderma).
Chronic inflammatory bowel diseases (Crohn’s disease, ulcerative colitis).
Allergic diseases.
Characterization and function of innate immune cells and T lymphocytes in tissue of patients with chronic inflammatory diseases.
DRE HEENA MEHTA,
DRE MARIKA SARFATI
Centre de Recherche du CHUM
Laboratoire d’immunorégulation Université de Montréal
L’acquisition d’une instrumentation de pointe permet d’étudier de façon approfondie le
profil immunitaire dans le sang et les tissus. L’établissement d’un lien entre les différentes
présentations cliniques de la sclérodermie et les acteurs du système immunitaire à un
moment donné de la maladie ouvrira la voie à l’identification de nouvelles cibles thérapeutiques et de nouvelles approches de prise en charge clinique du patient.
Interstitial Lung Disease in Systemic Sclerosis: Should Mild Disease Be Treated?
by Dr. Sabrina Hoa
Dr. Sasha Bernatsky, Gaetan Baril, President of Scleroderma Quebec, Dr. Sabrina Hoa and Dr. Marie Hudson
Systemic sclerosis (SSc) is a rare autoimmune disease characterized by various degrees of skin fibrosis and internal organ involvement. Interstitial lung disease (ILD), or pulmonary fibrosis, is a common complication of SSc, affecting up to 50% of patients. Immunosuppressive drugs are currently used to treat SSc-ILD, particularly in patients with pulmonary symptoms (e.g. shortness of breath or cough), severe lung function impairment, or progressive worsening disease. However, the usefulness of these drugs in patients with normal or mildly impaired lung function is currently unclear, given that this patient population was mostly excluded from randomized controlled trials. Yet, SSc-ILD with normal or mildly impaired lung function is frequent, representing approximately half of all SSc-ILD patients.
In the course of her Masters of Epidemiology thesis project at McGill University, Dr. Hoa was interested in exploring the role of immunosuppressive drugs, namely cyclophosphamide and mycophenolate mofetil, in the treatment of patients with mild SSc-ILD. Using data collected in the Canadian Scleroderma Research Group (CSRG) registry from 2004 to 2017, she studied the characteristics and outcomes of 116 patients with mild SSc-ILD. About 10% of these patients were exposed to cyclophosphamide or mycophenolate mofetil mostly for joint and skin disease. After one year, the forced vital capacity (a measure of lung function) of patients who were exposed to these drugs was compared with that of patients who were not exposed to these drugs.
What were the results? Patients with mild SSc-ILD who were exposed to immunosuppressive drugs for reasons other than lung disease had better lung function test results at one year compared to patients who were not exposed, even after adjusting for baseline lung function values, disease duration, extent of skin disease and shortness of breath scores. Moreover, none of the patients who were exposed to immunosuppressive drugs progressed over the next two years, whereas up to 25% of patients who were not exposed to these drugs progressed over this timeframe.
These preliminary results are very interesting in that they suggest that immunosuppressive drugs may have a disease-modifying role in the treatment of early SSc-ILD. Future randomized controlled studies looking at efficacy of therapies in SSc-ILD should include patients with mild SSc-ILD, as these patients may also benefit from disease-altering therapies. Further research also needs to be done to better characterize the predictors of disease progression among patients with mild SSc-ILD.
Dr. Hoa has now completed her Masters of Epidemiology and is very grateful to her supervisors, Dr. Marie Hudson and Dr. Sasha Bernatsky, for their exceptional mentorship. She is also thankful to Dr. Murray Baron, director of the CSRG, and all the patients and researchers who have contributed to the richness of the CSRG registry. She is deeply grateful to Sclérodermie Québec, the Scleroderma Research Chair of the University of Montreal, The Arthritis Society, the Canadian Institutes for Health Research and the Centre Hospitalier de l’Université de Montréal (CHUM) Foundation for their financial support during her postdoctoral fellowship training. Dr. Hoa has now been appointed Assistant Professor in the Department of Medicine, Faculty of Medicine, at University of Montreal and in the Division of Rheumatology at the CHUM. As a clinician-researcher, she hopes to further knowledge on the optimal use of therapies to improve outcomes of all people affected by scleroderma.
Sabrina Hoa, MD MSc FRCPC, est rhumatologue, membre du Service de rhumatologie du CHUM, professeure adjointe de clinique au Département de médecine de l’Université de Montréal et chercheure au Centre de Recherche du CHUM.
Dre Hoa a complété une formation post-doctorale en sclérodermie systémique et une Maîtrise en Épidémiologie à l’Université McGill. Son mémoire portait sur le rôle des traitements immunosuppresseurs dans la maladie pulmonaire interstitielle légère associée à la sclérodermie, ainsi que sur le rôle de ces traitements dans la prévention de la maladie pulmonaire. Sa formation était subventionnée par une bourse de maîtrise des Instituts de recherche en santé du Canada (IRSC) et par une bourse post-doctorale de la Société d’arthrite. Ses travaux de recherche ont été sélectionnés par la Société d’arthrite comme faisant partie des 10 principales percées de la recherche en 2019.
Hoa S, Bernatsky S, Steele RJ, Baron M, Hudson M. Association between immunosuppressive therapy and course of mild interstitial lung disease in systemic sclerosis. Rheumatology (Oxford). 2020 May 1;59(5) :1108-1117.
Hoa S, Stern EP, Denton CP, Hudson M. Towards developing criteria for scleroderma renal crisis: A scoping review. Autoimmunity Reviews (2017) 16: 407-415.
Caron M, Hoa S, Hudson M, Schwartzman K, Steele RJ. Pulmonary function tests as outcomes for systemic sclerosis interstitial lung disease. European Respiratory Review (2018) 27: 1-16.
Hoa S, Leclair V, Hudson M. Cutaneous lymphangiectasia in systemic sclerosis. Arthritis & Rheumatology (2017) 69(2): 446.
Hoa S, Hudson M, Troyanov Y, Proudman S, Walker J, Stevens W, Nikpour M, Assassi S, Mayes MD, Wang M, Baron M, Fritzler MJ, Canadian Scleroderma Research Group (CSRG), Australian Scleroderma Interest Group (ASIG), Genetics versus Environment in Scleroderma Outcome Study (GENISOS). Single-specificity anti-Ku antibodies in an international cohort of 2140 systemic sclerosis subjects: clinical associations. Medicine (Baltimore) (2016) 95: e4713.
Scientifique cherchant à utiliser ma vaste expérience pratique des maladies infectieuses, des vaccins et de l’auto-immunité dans le domaine des soins de santé.
Dr. Marie Hudson is a rheumatologist, epidemiologist, and Assistant Professor in the Department of Medicine at McGill University. She is a physician-scientist and member of the Center for Clinical Epidemiology and Community Studies at the Jewish General Hospital. She is a fellow of the Royal College of Physicians of Canada and is funded as a New Investigator by the Canadian Institutes of Health Research (CIHR).
She is the recipient of the 2011 Canadian Rheumatology Association Young Investigator Award.
Recent PublicationsHudson M, Fritzler MJ, Baron M. Systemic sclerosis: Establishing diagnostic criteria. Medicine (Baltimore) 2010; 89(3): 159-65.
Hudson M, Thombs BD, Steele R, Panopalis P, Newton E, Baron M, Canadian Scleroderma Research Group. Health-related quality of life in Systemic Sclerosis: A systematic review. Arthritis Rheum 2009; 61(8): 1112-20.
Senior Investigator, Centre for Clinical Epidemiology, Lady Davis Institute
Associate Professor, Department of Oncology, Department of Epidemiology, Biostatistics and Occupational Health, and Division of Cancer Epidemiology, McGill University
Recent Publications
Celia MT Greenwood, Shuying Sun, Justin Veenstra, Nancy Hamel, Bethany Niell, Stephen Gruber, William D Foulkes (2010). How old is this mutation? A study of three Ashkenazi Jewish founder mutations. BMC Genetics 11:39.