Maybe it’s the soft trace of a southern accent, or the respect he accords even ordinary questions. Whatever the clue, you quickly perceive that John T. Sharp, MD, is both a gracious and an authoritative person. Perhaps it is this disarming combination of qualities that most endears Dr. Sharp to his fellow rheumatologists, many of whom regard him as a giant in the field of RA—and not just because he created the Sharp score, a standardized outcome measure for tracking RA progression.
“I have known John for 15 years,” says Lee S. Simon, MD, associate clinical professor of medicine at Harvard Medical School in Boston and former division director of the Arthritis, Analgesic, and Ophthalmologic Drug Product Division at the Food and Drug Administration’s (FDA’s) Center for Drug Evaluation and Research. “But, in those years, he has always been this unassuming, modest kind of guy with impeccable manners. He never interrupts anybody, he never pushes his theory in front of somebody else’s theory, and he allows people to talk. Even when there is an argument, he just continues to ‘plug away’ on the evidence, which he knows quite well.”
Vibeke Strand, MD, adjunct clinical professor of medicine in the Division of Immunology at Stanford University and a biopharmaceutical consultant who has worked with Dr. Sharp on numerous development programs on treatments for RA, agrees. “He’s very modest and unassuming, and he’s always bringing people together,” says Dr. Strand. “He’s a real delight, and it’s really a pleasure always to continue to learn from and work with him.”
Throughout his nearly six decade–long career, Dr. Sharp’s keen intelligence and passion for standardized outcome measures have led him on a path of discovery that some have called courageous. According to other top rheumatologists and drug researchers interviewed for this article, the last 15 years of pharmacologic advances in RA would not have been possible without a quantitative measure for evaluating disease progression—a measure made possible by Dr. Sharp’s seminal work in the 1960s and early 1970s.
How did the idea for such a method come about? And how did Dr. Sharp pioneer this method of quantitatively assessing erosions and joint space narrowing to measure progression of RA over time? During two recent afternoon conversations from his home on Bainbridge Island near Seattle, Dr. Sharp amiably agreed to talk about the influences on his career and the scoring technique he developed.
“I tell this story—and it’s almost true,” he begins wryly. “I sat down one afternoon and in a couple of hours designed the whole system. Of course, having designed it, it took six months, a year, maybe even a bit longer, to collect the data to show that it was an appropriate measure, and that it correlated with the features of clinical outcomes that were important.”
Throughout his nearly six decade–long career, Dr. Sharp’s keen intelligence and passion for standardized outcome measures have led him on a path of discovery that some have called courageous.
Of course, many events and influences led to that afternoon’s work, including Dr. Sharp’s reasons for entering the specialty in the first place.
Why Rheumatology?
As a young resident, Dr. Sharp had been fascinated with rheumatic fever. Realizing that he could not specialize in one disease, he began to consider cardiology, infectious disease, or rheumatology. Of the three specialties, he thought that rheumatology offered more challenges and began looking for a fellowship program.
