Research

Summary

I have worked in diverse disease areas of neurology, cardiology, and cancer. My current interests are around substance use.

Substance use

My interests in substance use began during my time as an analyst for the Seek, Test, Treat, Retain consortium in HIV. Here I worked on creating several harmonized data domains for 22 cohort studies and clinical trials evaluating people living with HIV (PLWH) and those at risk for HIV. The CHSCC was the data coordinating center for this effort. I led a project currently in submission evaluating the association between individual substance use (alcohol and illicit drugs) and substance use frequency and self-reported adherence to antiretroviral therapies (ART).

Chandler R, Gordon MS, Kruszka B, et al. Cohort profile: seek, test, treat and retain United States criminal justice cohort. Subst Abuse Treat Prev Policy. 2017;12(1):24. doi:10.1186/s13011-017-0107-4.

Perez Trejo M, Strand L, Nance R, et al. The role of gender as an effect measure modifier in the Seek, Test, Treat, Retain (STTR) HIV Consortium: evaluating the relationship between antiretroviral adherence and poly-substance use. Accepted to the 33rd International Conference on Pharmacoepidemiology and Therapeutic Risk Management, August 2017, Montreal Canada. * Co-first authors.

Mackesy-Amiti M, Strand L, Nance R, et al. An example of exposure heterogeneity when pooling epidemiologic studies for meta-analysis of antiretroviral medication adherence. Presented at the 32nd International Conference on Pharmacoepidemiology and Therapeutic Risk Management, August 2016, Dublin, Ireland*

Cardiovascular Epidemiology/Pharmacoepidemiology

Statins are reported to have pleiotropic effects that may be beneficial to cardiovascular health outside their capacity to lower cholesterol. However, statins are known have negative effects on skeletal muscle, with reported cases of myopathy in some patients.  My thesis work focused on the effect of statin use on the structure of the heart. To date, only small and short‐term studies have investigated statins and heart structure.  This study in a large, diverse cohort demonstrated a modest association between statin use and reduced remodeling of the left ventricle in a propensity score matched model. Overall findings suggest that a statin effect on cardiac remodeling is not the main mechanism of statin benefit in the primary prevention of heart failure.

Strand LN, Young RL, Bertoni AG, et al. New statin use and left ventricular structure: estimating long‐term associations in the Multi‐Ethnic Study of Atherosclerosis (MESA). In press.

Neurology

Clinically isolated syndrome (CIS) is a first neurologic event suggestive of multiple sclerosis (MS) that precedes the majority of MS cases.  Several disease-modifying therapies (DMTs) have been shown to delay the conversion to clinically definite multiple sclerosis (CDMS); however, there is some debate over the early use of these costly treatments, for which long-term disability benefits are unknown. The phase 3 BENEFIT trial evaluated early treatment versus delayed treatment with interferon beta-1b (IFN B-1b) with up to 11-years follow-up. We designed a model to evaluate the cost-effectiveness of early treatment of CIS using subcutaneous IFNB-1b from a United-States (US) payer perspective.

Strand L, Zimmermann M, Carlson J, Hansen R. Cost-utility of early versus delayed treatment with interferon beta-1b in clinically isolated syndrome from a United States payer perspective. Accepted to the International Society for Pharmacoeconomics and Outcomes Research Annual Conference in May 2017, Boston MA.

Cancer

During my time at Evidera, I worked on a systematic review and meta-analysis of progression-free survival in gastrointestinal stromal tumor (GIST) clinical trials.  This was the culmination of my methods training at Evidera in meta-analysis.

Özer-Stillman I, Strand L, Chang J, Mohamed AF, Tranbarger-Freier KE. Meta-analysis for the association between overall survival and progression-free survival in gastrointestinal stromal tumor. Clin Cancer Res. 2015;21(2):295-302. doi:10.1158/1078-0432.CCR-14-1779.