Dr Halina FitzClarence

Dr Halina FitzClarenceTel: 020 3447 9487
Fax: 020 3447 9278
Email: uclh.rheumatology@nhs.net

Location:
University College Hospital

Specialities:
Rheumatology

Professional background

Dr. Halina FitzClarence is a consultant rheumatologist based at University College Hospital.  She completed her training at the Institute of Rheumatology (Poland) and the Middlesex Hospital, where she was initially a British Council Scholar, supervised by Dr. Mary Corbett, Dr. Michael Shipley and POrofessor Frank Hay.  She was subsequently awarded a prestigious research fellowship from the Arthritis Research Council (ARC), her research being supervised by Professor David Isenberg.  As a trainee she also visited leading osteoporosis centres, including the Mayo Clinic and the Charité Hospital, Berlin.
 
Dr. FitzClarence specialises in the field of adult osteoporosis and Vitamin D deficiency.  Her particular clinical expertise and interests are secondary osteoporosis, including drug-induced osteoporosis ( e.g. steroids,   aromatase inhibitors ,  anti-androgens , medication for retroviral diseases ), and bone disease in the course of neoplasia  (breast, prostate) , HIV, connective tissue diseases and eating disorders.
 
In 1997 she established the osteoporosis clinic at UCLH in collaboration with the late Professor Michael Horton,  initially through the charitable donations of the Hedley Trust, the Sackler Foundation and unrestricted educational grants of pharmaceutical companies.  A comprehensive service for the diagnosis and long-term management of various forms of osteoporosis has been developed over subsequent years, including  Fracture  Liaison  Service  within   the Orthopaedic Department and Intravenous Bisphosphonate Infusion Clinic.
   
In collaboration with the late  Professor  Horton, Dr.  Jonathan Chamberlain and Professor Mark Thomas she created  " Genomic and integrated proteomic sample banking initiative in subjects with densitometrically defined osteoporosis " .  This initiative, which is on-going, has enabled  their team   to analyse blood samples of patients on intravenous biphosphonates, on the basis of which Dr. FitzClarence, Dr. Chamberlain and Professor Mark Thomas obtained  in 2007  a patent (Bio Markers for Biphosphonate-responsive bone disorders).  The patented invention (financed by UCL Biomedica ) identifies genetic variations  at  and  around  the  farnesyl diphosphate synthase  gene  (FDPS) of chromosome 1  which can predict whether or not a patient will respond to treatment with biphosphonates.  The identification of non-responding individuals holds the potential to facilitate patients receiving a more appropriate course of treatment.  It is believed that the market for a  diagnostic  assay of this type is extremely  important  world-wide  and potentially it could be a part of a personalised medicine programme .  It is felt that in the near future all patients about to start this treatment for osteoporosis   can have genetic sequencing of FDPS gene to demonstrate  their ability to respond to the treatment regime.
 
The patent  was  bought by the Cambridge Biotech Company  in 2011 and awaits validation.
 
Dr. FitzClarence has also been a contributor to the  creation of the National Hip Fracture Database (NHFD) in close collaboration with Professor David Marsh, and she is  a  Clinical  Lead for the NHFD at UCLH, being supported by an orthopaedic trauma nurse and a team of orthopaedic surgeons.
   
Her most recent undertakings, in view of changes within the NHS structure, include strategies of transfer of care of patients with primary osteoporosis  to  primary care   (involving pharmacists and nurse specialists)  and utilisation of new technologies, including telemedicine .  
 
She co-supervises  the PhD of Sarah Besser from London University on   "Adherence to Medication in Osteoporosis" .

Research interests

Personalised medicine with the use of bio-markers of response to treatment with  bisphosphomates.
 
Utilisation of the results of National Hip Fracture Database (NHFD) to improve care of patients following hip fracture.
 
Barriers to the adherence of long-term treatment for osteoporisis (role of psychologists, nurse specialists, self-support patient groups, charitable organisations).

Publications

Balasegaram, S., Majeed, A., FitzClarence, H. , Trends in hospital admissions for fractures in England - 1989/90 to 1997/98.  Health Statistics Quarterly 2000, 7:  10-17.

Balasegaram, S., Majeed, A.,  FitzClarence, H.   Trendds in hospital admissions for fractures of the femur in England - 1989/90 - 1997/98.  Journal of Public Health Medicine 2001, 23:  11-17.

Taylor, J. C.,  Sterkel, B., Utley, M., Shipley, M., Newman, S., Horton, M.,
 FitzClarence, H.   Opinions and experiences in general practice on osteoporosis prevention, diagnosis and management.  Osteoporosis International 23001,  12:  844-848

Balasegaram, S., Majeed, A., FitzClarence, H.   Trends in hospital admissions for fractures of the femur in England - 1989/90 - 1997/98.  Journal of Public Health Medicine 2001, 23:  11-17.


Book reviews

FitzClarence, H.   Bone Densitometry for Technologists, by S. L. Bonnick and L. A. LEWIS.  Humana Press, Totowa, NJ 2001, pages ISBN 1 58829 020 4.


Patent

Chamberlain, J, FitzClarence, H., Thomas, M.

Biomarkers for Bisphosphonate-Responsive Bone  Disorders
Patent on International Publication No. WO2007/107717 A1, International Publication Date 27/09/2007.

 

GMC/GDC number: 3647422