Dr Halina Fitz-Clarence

Dr Halina Fitz-Clarence held an NHS substantive post of Consultant Rheumatologist based at University College Hospital for almost 20 years (01/04/1996 – 01/04/2015). She has completed 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 Professor Frank Hay. She was subsequently awarded a prestigious research fellowship from the Arthritis Research Council (ARC), my research being supervised by Professor David Isenberg. As a trainee she also visited leading osteoporosis centres, including the Mayo Clinic, USA, Charite Hospital, Berlin and Aachen University.

Dr Halina Fitz-Clarence 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 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 Bisphosphonates 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 ongoing, has enabled this team to analyse blood samples of patients on intravenous bisphosphonates, on the basis of which Dr Halina Fitz-Clarence, Dr Chamberlain and Professor Mark Thomas obtained in 2007 a patent (Bio Markers for Bisphosphonate-responsive bone disorders). The patented invention (financed by UCL, Biomedical) 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 bisphosphonates. 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 commence this treatment for osteoporosis potentially can have genetic sequencing of FDPS gene to demonstrate their ability to respond to the treatment regime.

The patent was purchased by the Cambridge Biotech Company.

Dr Fitz-Clarence have also been a contributor to the creation of the National Hip Fracture Database (NHFD) in close collaboration with Professor David Marsh, and she was Clinical Lead for the NHFD at UCLH, being supported by the orthopaedic trauma nurse and a team of orthopaedic surgeons.

Her most recent undertaking, in view of changes within the NHS structure, include strategies of transfer of care of patients with primary osteoporosis to primary care (involving pharmacist, nurse specialists and patient support groups) and utilisation of new technologies including telemedicine.

Dr Fitz-Clarence also takes self pay patients.