Rheumatology Commons^™

Practice-Based Education Program To Increase Vaccination Rate In Patients On Immunotherapeutic Agents, Andrea M. Soliman Do, Soorya N. Aggarwal Do, Kyle Kreitman Do, Kourtney Erickson Do, Abdul Aleem Md, Marie S. O'Brien Do

Department of Medicine

No abstract provided.

Pain, Functional Disability, And Their Association In Juvenile Fibromyalgia Compared To Other Pediatric Rheumatic Diseases., Mark Connelly, Jennifer E Weiss, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe pain and impairments in functioning are commonly reported for youth with juvenile fibromyalgia. The prevalence and impact of pain in other diseases commonly managed in pediatric rheumatology comparatively have been rarely systematically studied. The objective of the current study was to determine the extent to which high levels of pain and functional limitations, and the strength of their association, are unique to youth with juvenile primary fibromyalgia syndrome/JPFS) relative to other pediatric rheumatic diseases.

METHODS: Using data from 7753 patients enrolled in the multinational Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry, we compared the levels and …

Dry Eyes, Dry Mouth, And Amyloidosis – A Case Report, Andrea M. Soliman Do, Grace Guerrier Md, Carolyn Casey Do, Shereen M F Gheith Md, Phd

Department of Medicine

No abstract provided.

Screening And Treating Hyperlipidemia In Patients On Tofacitinib, Tocilizumab, Sarilumab, And Baricitinib, William Torelli Do, Thomas A. Quinn Do, Kourtney Erickson Do, Andrea M. Soliman Do, Attiya Harit Ms, James Ross Md, Facp

Department of Medicine

No abstract provided.

Case Report: Too Thick To Test, William Torelli Do, Rebecca Sharim Md

Department of Medicine

No abstract provided.

Rapidly Progressive Rheumatoid Lung Disease, Alaynna C. Kears Do, Nathan Brewster Do, Andrea M. Soliman Do, Stacey Smith Md, Facp, James Ross Md, Facp

Department of Medicine

No abstract provided.

Implementing Treat To Target Approach In The Care Of Children With Juvenile Idiopathic Arthritis, Julia G. Harris, Jamie Holland, Emily Fox, Leslie Favier, Ashley M. Cooper

Posters

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory disease seen in pediatric rheumatology. Despite advances in biologic therapy, many children with JIA will experience morbidity. Treat to Target is a treatment paradigm that involves setting a target of disease activity, using shared decision making, and incorporating clinical decision support. Our clinic aimed to set a treatment target on 50% of eligible JIA patients by December 31, 2019.

Collaboration Between Rheumatology Clinic And Specialty Pharmacy To Positively Impact Patient Experience And Hospital Stewardship, Alaina Linafelter, Julia G. Harris, Robert Herr, Stephanie Quinn, Ashley M. Cooper

Posters

Biologic medications are commonly utilized to treat pediatric rheumatic diseases. Being high-cost, most third-party payers require dispensing through a specialty pharmacy. Children's Mercy Hospital Specialty Pharmacy (CMH SP) started acceting patients in March 2015.

The number of patients benefited by the superior service of CMH SP has risen steadily, leading to high patient satisfaction and financial benefits for the hospital.

Improving Pneumococcal Vaccination Rates In High Risk Patients Across Multiple Specialty Divisions, Rachel Moran, Julia G. Harris, Claire Olsen, Rana El Feghaly, Liset Olarte, Douglas Blowey, Luke A. Harris

Posters

Pediatric patients with deficient immune systems or certain chronic medical conditions have an increased risk of acquiring invasive pneumococcal disease.

The 23-valent pneumococcal (PPSV23) vaccine provides protection against 23 pneumococcal serotypes and is recommended for patients aged 2 years or older who are high-risk for invasive pneumococcal disease.

Unfortunately, many high-risk patients are not properly vaccinated due to lack of provider knowledge or understanding of accountability between primary care and specialty providers.

The goal of this project was to improve PPSV23 vaccination rates by 10-20% across multiple Children's Mercy Kansas City specialty divisions.

Don’T Be Blind To The Diagnosis: An Intriguing Case Of Monocular Blindness, Kourtney Erickson Do, Kaitlyn L. Buzard Do, Daniel Tseytlin Do, Carolyn Casey Do, Eugene Alexandrin Md

Department of Medicine

No abstract provided.

Efficacy And Safety Of Intravenous Golimumab Plus Methotrexate In Patients With Rheumatoid Arthritis Aged < 65 Years And Those ≥ 65 Years Of Age., John Tesser, Shelly Kafka, Raphael J. Dehoratius, Stephen Xu, Elizabeth C Hsia, Anthony Turkiewicz

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: To evaluate the safety and efficacy of intravenous golimumab + methotrexate (MTX) in patients with active rheumatoid arthritis (RA) aged < 65 years and those ≥ 65 years who were enrolled in the GO-FURTHER study.

METHODS: In the phase III, double-blind, randomized, placebo-controlled GO-FURTHER trial, patients with active RA were randomized to intravenous (IV) golimumab 2 mg/kg + MTX or placebo + MTX at weeks 0 and 4, then every 8 weeks thereafter (with crossover to golimumab at week 16 [early escape] or week 24 [per-protocol]). The final golimumab infusion was at week 100. Assessments included American College of Rheumatology (ACR) 20/50/70 response criteria. Efficacy and adverse events (AEs) were monitored through 2 years. …

Demographic, Clinical, And Treatment Characteristics Of The Juvenile Primary Fibromyalgia Syndrome Cohort Enrolled In The Childhood Arthritis And Rheumatology Research Alliance Legacy Registry., Jennifer E. Weiss, Kenneth N. Schikler, Alexis D. Boneparth, Mark Connelly, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To describe the demographic, clinical, and treatment characteristics of youth diagnosed with juvenile primary fibromyalgia syndrome (JPFS) who are seen in pediatric rheumatology clinics.

METHODS: Information on demographics, symptoms, functioning, and treatments recommended and tried were obtained on patients with JPFS as part of a multi-site patient registry (the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry). Data were summarized using descriptive statistics. In a subset of patients completing registry follow-up visits, changes in symptoms, pain, and functioning were evaluated using growth modeling.

RESULTS: Of the 201 patients with JPFS enrolled in the registry, most were Caucasian/White (85%), non-Hispanic …

Physician Practices For Withdrawal Of Medications In Inactive Systemic Juvenile Arthritis, Childhood Arthritis And Rheumatology Research Alliance (Carra) Survey., Susan Shenoi, Kabita Nanda, Grant S. Schulert, John F. Bohnsack, Ashley M. Cooper, Bridget Edghill, Miriah C. Gillispie-Taylor, Baruch Goldberg, Olha Halyabar, Thomas G. Mason, Tova Ronis, Rayfel Schneider, Richard K. Vehe, Karen Onel, Childhood Arthritis And Rheumatology Research Alliance Systemic Juvenile Idiopathic Arthritis Workgroup

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: We describe a Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey of North American pediatric rheumatologists that assesses physician attitudes on withdrawal of medications in systemic juvenile idiopathic arthritis (SJIA).

METHODS: A REDCap anonymous electronic survey was distributed to 100 random CARRA JIA workgroup physician-voting members. The survey had three broad sections including: A) demographic information; B) physicians' opinions on clinical inactive disease (CID) in SJIA and C) existing practices for withdrawing medications in SJIA.

RESULTS: The survey had an 86% response rate. 88 and 93% of participants agreed with the current criteria for CID and clinical remission on …

Developing Comparative Effectiveness Studies For A Rare, Understudied Pediatric Disease: Lessons Learned From The Carra Juvenile Localized Scleroderma Consensus Treatment Plan Pilot Study., Suzanne C. Li, Robert C. Fuhlbrigge, Ronald M. Laxer, Elena Pope, Maria Ibarra, Katie Stewart, Thomas Mason, Mara L. Becker, Sandy Hong, Fatma Dedeoglu, Kathryn S. Torok, C Egla Rabinovich, Polly J. Ferguson, Marilynn Punaro, Brian M. Feldman, Tracy Andrews, Gloria C. Higgins, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: We designed and initiated a pilot comparative effectiveness study for juvenile localized scleroderma (jLS), for which there is limited evidence on best therapy. We evaluated the process we used, in relation to the specific protocol and to the general task of identifying strategies for implementing studies in rare pediatric diseases.

METHODS: This was a prospective, multi-center, observational cohort study of 50 jLS patients initiating treatment, designed and conducted by the jLS group of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) from 2012 to 2015. A series of virtual and physical meetings were held to design the study, standardize …

Consumer Prices For Surgical Management Of Ankle Arthritis: Limited Availability And Wide Variability., Niall A Smyth, Brody J Dawkins, Joshua P Goldstein, Jonathan R Kaplan, Lew C Schon, Amiethab A Aiyer

Articles, Abstracts, and Reports

Background: Healthcare costs for the surgical management of ankle arthritis continue to rise. Patients are generally unaware of the prices of the services they use. Understanding the costs associated with surgical management of ankle arthritis is an important facet of patient care. The purposes of this study were to (1) determine the access to the surgical cost of total ankle arthroplasty (TAAs) and ankle arthrodesis and (2) the variability of the price between the two procedures.

Methods: Fifty foot and ankle centers (25 academic, 25 private) that perform TAAs and ankle arthrodeses were contacted using a standardized patient script. The …

Long-Term Experience With Apremilast In Patients With Psoriatic Arthritis: 5-Year Results From A Palace 1-3 Pooled Analysis., Arthur Kavanaugh, Dafna D Gladman, Christopher J Edwards, Georg Schett, Benoit Guerette, Nikolay Delev, Lichen Teng, Maria Paris, Philip Mease

Articles, Abstracts, and Reports

BACKGROUND: The efficacy and safety of apremilast were assessed in patients with psoriatic arthritis (PsA) in three phase III clinical trials with similar designs (PALACE 1, 2, and 3).

METHODS: Following a 24-week, randomized (1:1:1 to apremilast 30 mg twice daily, 20 mg twice daily, or placebo), double-blind phase and a 28-week blinded active treatment phase, patients could receive apremilast in open-label extension studies for an additional 4 years. Eligible adult patients had active PsA for ≥ 6 months and three or more swollen joints and three or more tender joints despite prior treatment with disease-modifying anti-rheumatic drugs.

RESULTS: A …

Long-Term Safety Of Secukinumab In Patients With Moderate-To-Severe Plaque Psoriasis, Psoriatic Arthritis, And Ankylosing Spondylitis: Integrated Pooled Clinical Trial And Post-Marketing Surveillance Data., A Deodhar, Philip Mease, I B Mcinnes, X Baraliakos, K Reich, A Blauvelt, C Leonardi, B Porter, A Das Gupta, A Widmer, L Pricop, T Fox

Articles, Abstracts, and Reports

BACKGROUND: Secukinumab, a fully human immunoglobulin G1-kappa monoclonal antibody that directly inhibits interleukin (IL)-17A, has been shown to have robust efficacy in the treatment of moderate-to-severe psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) demonstrating a rapid onset of action and sustained long-term clinical responses with a consistently favorable safety profile in multiple Phase 2 and 3 trials. Here, we report longer-term pooled safety and tolerability data for secukinumab across three indications (up to 5 years of treatment in PsO and PsA; up to 4 years in AS).

METHODS: The integrated clinical trial safety dataset included data pooled from …

Rhabdomyolysis: An Unusual Presenting Symptom Of Hypothyroidism, Kourtney Erickson Do, Grace Berlin Do, Marie S. O’Brien Do

Department of Medicine

No abstract provided.

Obstructive Sleep Apnea Co-Morbidity In Patients With Fibromyalgia: A Single-Center Retrospective Analysis And Literature Review, Edwin S. Meresh, Hewa Artin, Cara Joyce, Steven Birch, David Daniels, Jack H. Owens, Alvaro J. La Rosa, Murali S. Rao, Angelos Halaris

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Fibromyalgia (FM) is a chronic medical condition characterized by widespread pain, sleep disturbance, and cognitive dysfunction. Sleep disorders are thought to play a prominent role in the etiology and symptomatic management of FM, specifically obstructive sleep apnea (OSA). In order to provide collaborative care, we need a better understanding of any overlapping presentation of FM and OSA. We conducted a site-wide review of patients from 2012–2016 to identify FM patients diagnosed with OSA.

Methods: Charts were reviewed in patients aged 18 and above from 2012–2016 using ICD codes from a clinical data repository. Intersection of patients with a diagnosis …

The Effect Of Glucosamine, Chondroitin And Harpagophytum Procumbens On Femoral Hyaline Cartilage Thickness In Patients With Knee Osteoarthritis– An Mri Versus Ultrasonography Study, Florentin Ananu Vreju, Paulina Lucia Ciurea, Anca Rosu, Beatrice Andreea Chisalau, Cristina Dorina Parvanescu, Sineta Cristina Firulescu, Adina Turcu Stiolica, Andreea Lili Barbulescu, Stefan Cristian Dinescu, Cristiana Iulia Dumitrescu, Roxana Mihaela Dumitrascu, Cristina Criveanu, Lucretiu Radu, Mihai Tusaliu, Daniela Dumitrescu

Journal of Mind and Medical Sciences

Background: the evaluation of cartilage thickness has become possible with new techniques such as musculoskeletal ultrasonography (US) and magnetic resonance imagining (MRI), making the evaluation of the treatment response and the progression of the disease more accurate. Objective: to evaluate the efficacy of a Symptomatic Slow Acting Drug for Osteoarthritis using both US and MRI for measuring cartilage thickness at baseline and after 1 year. Methods: The study included the clinical evaluation of 20 patients at baseline, at 6 and 12 months as well as imaging exams (US and MRI) at baseline and after 1 year. Measurements …