February 7, 2019

TRI Helps Busy Neurosurgeon Lead Multiple Studies

Erika Petersen, M.D., saw the outlines of her career when she was just 16. As a participant in a summer research program at Duke Cancer Institute, she gained insights beyond the lab work.

“As part of the program, I got to stand beside an anesthesiologist and watch open-heart surgery,” she said. “That was the moment I knew I was interested in medicine.”

Petersen, a UAMS neurosurgeon and associate professor in the College of Medicine, also noted at the time how her Duke mentor, a breast oncologist, was able to run a research lab in addition to seeing patients.

“That helped me see a model of how doctors could do research in different ways,” she said.

Futuristic Therapies
Petersen came to UAMS in 2010 and sees patients at the Stephens Spine & Neurosciences Institute. Her expertise in neuromodulation is unique to the region, futuristic even, with her ability to use deep brain stimulation and implant other devices to treat movement disorders and chronic pain.

“I have a friend who jokes that I’m creating cyborgs,” she said.

She’s not, of course. But by working at the cutting edge of medicine, she can help patients who don’t respond to conventional therapies.

“When you meet people who have seen dozens of practitioners, and they come to you saying, ‘I’ve heard great things about you, can you please help me?’ you want to offer every single possibility you can,” Petersen said.

Unfortunately, some of her work isn’t covered by insurance because the procedures are still considered experimental. It’s distressing for her and her patients.

“The compassion to treat versus the business decision of coverage is frustrating, so I’m motivated to create the evidence that will remove the disconnect between the two,” she said.

Prolific PI
Although she has no protected time for research, Petersen has been a prolific principal investigator. She is overseeing two active industry-sponsored clinical trials and three more are in the works. The active studies are testing implanted nerve stimulation devices for chronic amputation pain and diabetic neuropathy. The pending studies will test devices designed for treating chronic back pain (failed back surgery syndrome), and headache pain, including migraines. Another study involves the use of stem cells for stroke patients.

Her leadership of multiple clinical trials is a lot of extra work, but it’s doable for a couple of reasons: One, she is able to blend the trials into her clinical practice, and two, she can get the clinical trial services she needs from the Translational Research Institute (TRI).

Leveraging TRI
“A single clinician with a single nurse doesn’t have the institutional context like TRI for navigating the regulatory issues, the budget negotiations, and legal negotiations,” Petersen said. “Having the team of coordinators at TRI who are backing each other up also ensures that a research participant always has support, and that’s been essential.”

TRI has also helped her promote her research to the general public. “A clinical trial is only as successful as what you can do through recruitment,” she said. “Working with TRI, we’ve done a lot in terms of media and outreach and in identifying subjects in the UAMS Epic (electronic medical record) system. So having those resources to help with recruiting is phenomenal.”

Despite her busy schedule, Petersen has appeared on four local broadcast stations to advocate for the amputation pain study and diabetic neuropathy study. Her public education efforts, which also include an active Twitter account, have contributed to her growing national reputation in the field. UAMS is among a select group of institutions chosen to conduct neuromodulation research. In fact, she said UAMS’ management of the amputation pain study will be a model used by Neuros, the sponsor, for the remaining research centers preparing for participant enrollment.

“When you have a good system and support to successfully manage the research, it leads to ongoing partnerships across multiple studies,” Petersen said.