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Article ; Online: A survey assessment of combined pediatric dermatology-rheumatology clinics.

Cherepakhin, Olga S / Ringold, Sarah / Ronis, Tova / Kirkorian, A Yasmine / Brandling-Bennett, Heather

2024

Abstract: The expertise of both dermatology and rheumatology may be beneficial when managing autoimmune conditions with cutaneous and systemic manifestations in children. This survey study was directed to pediatric dermatologists who participate in combined ... ...

Abstract	The expertise of both dermatology and rheumatology may be beneficial when managing autoimmune conditions with cutaneous and systemic manifestations in children. This survey study was directed to pediatric dermatologists who participate in combined pediatric dermatology-rheumatology clinics; 13 sites in North America responded. The results provide information regarding clinic operations, benefits, and barriers to establishment. These findings have the potential to help institutions establish or modify combined pediatric dermatology-rheumatology clinics, although further research is needed to determine their impact.
Language	English
Publishing date	2024-03-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.15588
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Article ; Online: Probability of Response in the First Sixteen Weeks After Starting Biologics: An Analysis of Juvenile Idiopathic Arthritis Biologics Trials.

Lim, Lily Siok Hoon / Lokku, Armend / Pullenayegum, Eleanor / Ringold, Sarah

Arthritis care & research

2023 Volume 75, Issue 6, Page(s) 1238–1249

Abstract: Objectives: Most juvenile idiopathic arthritis (JIA) biologic disease-modifying antirheumatic drugs (bDMARDs) trials used an open-label run-in period followed by randomized medication withdrawal. We used data from the run-in period of 4 bDMARD trials to ...

Abstract	Objectives: Most juvenile idiopathic arthritis (JIA) biologic disease-modifying antirheumatic drugs (bDMARDs) trials used an open-label run-in period followed by randomized medication withdrawal. We used data from the run-in period of 4 bDMARD trials to 1) delineate early response trajectory to bDMARDs and 2) identify predictors of early response. Methods: Data from the first 16 weeks of 4 bDMARD trials were used. The primary outcome was the American College of Rheumatology (ACR) Pediatric 50 (Pedi 50) response criteria: clinically significant response defined as ACR Pedi 50 or greater. The secondary outcome was the clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10) minimal disease activity state. Response transition rates and predictors were modeled using an inhomogeneous Markov multistate model. Results: Five hundred thirty-two participants (70% receiving methotrexate, 41% prednisone) were included. By month 4, the probability of attaining ACR Pedi 50 or greater was 0.698. If ACR Pedi 50 or more was not achieved by month 1, the probability of achieving it by month 4 was 0.60. If ACR Pedi 50 or more was not achieved by month 3, the probability of achieving this by month 4 was 0.31. Age at diagnosis, disease duration, baseline rheumatoid factor, and active joint counts predicted ACR and cJADAS state transitions, adjusted for concomitant treatment. Conclusions: No response ACR Pedi 50 or more by month 1 after treatment was associated with a 0.60 probability of responding by month 4, but not responding by month 3 was associated with a 0.31 probability of response by month 4. Baseline disease duration, rheumatoid factor, and active joint counts predicted early treatment response (ACR and cJADAS10 states).
MeSH term(s)	Child ; Humans ; Antirheumatic Agents/adverse effects ; Arthritis, Juvenile/diagnosis ; Arthritis, Juvenile/drug therapy ; Biological Products/adverse effects ; Methotrexate/adverse effects ; Rheumatoid Factor ; Treatment Outcome
Chemical Substances	Antirheumatic Agents ; Biological Products ; Methotrexate (YL5FZ2Y5U1) ; Rheumatoid Factor (9009-79-4)
Language	English
Publishing date	2023-01-18
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.25003
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Zs.A 2446: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.A 24: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Outcome Measures in Pediatric Rheumatic Disease.

Ringold, Sarah / Consolaro, Alessandro / Ardoin, Stacy P

Rheumatic diseases clinics of North America

2021 Volume 47, Issue 4, Page(s) 655–668

Abstract: Reliable and responsive outcome measures that accurately detect changes in disease state, activity, and damage are crucial to conducting observational and interventional trials that can directly transform care for children with rheumatic disease. A ... ...

Abstract	Reliable and responsive outcome measures that accurately detect changes in disease state, activity, and damage are crucial to conducting observational and interventional trials that can directly transform care for children with rheumatic disease. A combination of consensus-based and direct measurement approaches has led to the development of several validated, composite outcome measures in juvenile idiopathic arthritis, juvenile dermatomyositis, childhood-onset systemic lupus erythematosus, and pediatric vasculitis. This review outlines clinician-reported, disease-specific outcome measures developed for these conditions.
MeSH term(s)	Arthritis, Juvenile/therapy ; Child ; Dermatomyositis/diagnosis ; Dermatomyositis/therapy ; Humans ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/therapy ; Outcome Assessment, Health Care ; Rheumatic Diseases/therapy
Language	English
Publishing date	2021-09-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	92118-x
ISSN	1558-3163 ; 0889-857X
ISSN (online)	1558-3163
ISSN	0889-857X
DOI	10.1016/j.rdc.2021.07.013
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Article ; Online: Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials.

Lim, Lily Siok Hoon / Shobhan, Shamsia / Lokku, Armend / Ringold, Sarah / Pullenayegum, Eleanor

Pediatric rheumatology online journal

2022 Volume 20, Issue 1, Page(s) 57

Abstract: Aims: 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response.: Methods: The study population was ... ...

Abstract	Aims: 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response. Methods: The study population was drawn from four biologics trials in polyarticular course JIA: Etanercept 2000, Abatacept 2008, TRial of Early Aggressive Therapy (TREAT) 2012 and Tocilizumab 2014. The outcome was active joint counts (AJC). Semiparametric latent class trajectory analysis was applied to identify latent classes of response to treatment; AJC was transformed for this modelling. We tested baseline disease and treatment characteristics for their abilities to predict class membership of response. Results: There were 480 participants, 74% females. At baseline, 26% were rheumatoid factor positive. 67% were on methotrexate at enrollment. Three latent class solution provided the best fit. Baseline AJC was the sole best predictor of class membership. Participants classified by their highest membership probabilities into high baseline AJC (> 30) and slow response (26.5%), low baseline AJC (< 10), early and sustained response (29.7%), and moderate baseline AJC progressive response (43.8%). Participants were classified into the latent classes with a mean class membership posterior probability of 0.97. Those on methotrexate at baseline were less likely to belong to high baseline AJC class. Conclusions: Three latent classes of responses were detectable in the first 16 weeks of biologics therapy. Those with the highest baseline AJC demonstrated very slow response in this window and were less likely to be on concomitant methotrexate. Trials registration: TREAT 2012 (NCT NCT00443430 ) (Wallace et. al, Arthritis Rheum 64:2012-21, 2012), tocilizumab trial 2014 ( NCT00988221 ), abatacept trial 2008 ( NCT00095173 ). Etanercept 2000 from Amgen does not have a trial registration number.
MeSH term(s)	Abatacept/therapeutic use ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/drug therapy ; Biological Products/therapeutic use ; Etanercept/therapeutic use ; Female ; Humans ; Male ; Methotrexate/therapeutic use ; Treatment Outcome
Chemical Substances	Antirheumatic Agents ; Biological Products ; Abatacept (7D0YB67S97) ; Etanercept (OP401G7OJC) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2022-07-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-022-00719-1
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Article ; Online: Cutaneous polyarteritis nodosa in pediatric patients successfully treated with TNF-α inhibitor and methotrexate: Case series and literature review.

Do, Ngan / Ringold, Sarah / Brandling-Bennett, Heather

Pediatric dermatology

2019 Volume 36, Issue 6, Page(s) 932–935

Abstract: Cutaneous polyarteritis nodosa (CPAN) is a rare necrotizing vasculitis affecting small- to medium-sized arteries. Reported treatments include oral corticosteroids alone or in combination with non-steroidal antiinflammatory drugs, intravenous ... ...

Abstract	Cutaneous polyarteritis nodosa (CPAN) is a rare necrotizing vasculitis affecting small- to medium-sized arteries. Reported treatments include oral corticosteroids alone or in combination with non-steroidal antiinflammatory drugs, intravenous immunoglobulins, cyclophosphamide, azathioprine, colchicine, or dapsone. However, some patients with CPAN do not respond to such treatments and continue to experience exacerbations over prolonged periods. This series provides support for the use of TNF-α inhibitors in the treatment of recalcitrant CPAN in pediatric patients.
MeSH term(s)	Adolescent ; Dermatologic Agents/therapeutic use ; Drug Therapy, Combination ; Female ; Glucocorticoids/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Infliximab/therapeutic use ; Methotrexate/therapeutic use ; Methylprednisolone/therapeutic use ; Polyarteritis Nodosa/drug therapy ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
Chemical Substances	Dermatologic Agents ; Glucocorticoids ; Immunosuppressive Agents ; Tumor Necrosis Factor-alpha ; Infliximab (B72HH48FLU) ; Methylprednisolone (X4W7ZR7023) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2019-10-02
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.14005
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Article ; Online: A retrospective study: Impact of consensus treatment plans on systemic therapy of pediatric morphea.

Do, Ngan / Ringold, Sarah / Sullivan, Erin / Brandling-Bennett, Heather

Pediatric dermatology

2020 Volume 37, Issue 2, Page(s) 278–283

Abstract: Background: Morphea is an inflammatory and fibrosing condition that affects the skin and subcutaneous structures. Morphea is managed by dermatologists, rheumatologists, or both. Prior studies have suggested there is significant variability in approach ... ...

Abstract	Background: Morphea is an inflammatory and fibrosing condition that affects the skin and subcutaneous structures. Morphea is managed by dermatologists, rheumatologists, or both. Prior studies have suggested there is significant variability in approach to treatment. In 2012, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) published consensus treatment plans (CTPs) for pediatric morphea to develop more standardized treatment plans for patients requiring systemic therapy. We aimed to assess whether the publication of CTPs has impacted care of patients with morphea at our institution. Methods: Data were collected via a retrospective review of medical records of 61 pediatric patients diagnosed with morphea at Seattle Children's Hospital (SCH) from January 1, 2005, to December 12,2017. Results: Prior to the publication of CTPs, 2 out of 24 patients (8.3%) were treated with a regimen that matched a subsequent CTP. After publication of CTPs, 29 out of 37 patients (78.4%) were treated with a regimen that matched a CTP (P < 0.001). A subanalysis was performed to assess the number of patients who needed second- or third-line therapies. Of those who followed a CTP therapy plan (n = 26), 3 patients (11.5%) needed a second-line therapy compared with 11 patients (44%) in the no-CTP followed group (n = 25), (P = 0.012). Conclusions: The publication of CTPs led to a significant change in treatment approach for patients with morphea requiring systemic therapy at SCH. Patients treated with one of the treatment plans recommended by the CTPs were less likely to need second-line systemic therapy.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Clinical Protocols ; Consensus ; Dermatologic Agents/administration & dosage ; Female ; Glucocorticoids/administration & dosage ; Humans ; Male ; Methotrexate/administration & dosage ; Methylprednisolone/administration & dosage ; Retrospective Studies ; Scleroderma, Localized/drug therapy
Chemical Substances	Dermatologic Agents ; Glucocorticoids ; Methylprednisolone (X4W7ZR7023) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2020-01-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.14074
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Article ; Online: Improved Disease Course Associated With Early Initiation of Biologics in Polyarticular Juvenile Idiopathic Arthritis: Trajectory Analysis of a Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans Study.

Ong, Mei Sing / Ringold, Sarah / Kimura, Yukiko / Schanberg, Laura E / Tomlinson, George A / Natter, Marc D

Arthritis & rheumatology (Hoboken, N.J.)

2021 Volume 73, Issue 10, Page(s) 1910–1920

Abstract: Objective: To investigate the effects of early introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) on the disease course in untreated polyarticular juvenile idiopathic arthritis (JIA).: Methods: We analyzed data on patients with ... ...

Abstract	Objective: To investigate the effects of early introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) on the disease course in untreated polyarticular juvenile idiopathic arthritis (JIA). Methods: We analyzed data on patients with polyarticular JIA participating in the Start Time Optimization of Biologics in Polyarticular JIA (STOP-JIA) study (n = 400) and a comparator cohort (n = 248) from the Childhood Arthritis and Rheumatology Research Alliance Registry. Latent class trajectory modeling (LCTM) was applied to identify subgroups of patients with distinct disease courses based on disease activity (clinical Juvenile Arthritis Disease Activity Score in 10 joints) over 12 months from baseline. Results: In the STOP-JIA study, 198 subjects (49.5%) received bDMARDs within 3 months of baseline assessment. LCTM analyses generated 3 latent classes representing 3 distinct disease trajectories, characterized by slow, moderate, or rapid disease activity improvement over time. Subjects in the rapid improvement trajectory attained inactive disease within 6 months from baseline. Odds of being in the rapid improvement trajectory versus the slow improvement trajectory were 3.6 times as high (95% confidence interval 1.32-10.0; P = 0.013) for those treated with bDMARDs ≤3 months from baseline compared with subjects who started bDMARDs >3 months after baseline, after adjusting for demographic characteristics, clinical attributes, and baseline disease activity. Shorter disease duration at first rheumatology visit approached statistical significance as a predictor of favorable trajectory without bDMARD treatment. Conclusion: Starting bDMARDs within 3 months of baseline assessment is associated with more rapid achievement of inactive disease in subjects with untreated polyarticular JIA. These results demonstrate the utility of trajectory analysis of disease course as a method for determining treatment efficacy.
MeSH term(s)	Adolescent ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/drug therapy ; Biological Products/therapeutic use ; Child ; Consensus ; Disease Progression ; Female ; Humans ; Male ; Treatment Outcome
Chemical Substances	Antirheumatic Agents ; Biological Products
Language	English
Publishing date	2021-08-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.41892
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Article ; Online: Antidepressant warning focuses attention on unmet need for child psychiatrists.

Ringold, Sarah

JAMA

2005 Volume 293, Issue 5, Page(s) 537–538

MeSH term(s)	Adolescent ; Adolescent Psychiatry/standards ; Antidepressive Agents/adverse effects ; Antidepressive Agents/therapeutic use ; Child ; Child Psychiatry/standards ; Depressive Disorder/drug therapy ; Depressive Disorder/genetics ; Humans ; Practice Guidelines as Topic ; Receptors, Corticotropin-Releasing Hormone/genetics
Chemical Substances	Antidepressive Agents ; CRF receptor type 1 ; Receptors, Corticotropin-Releasing Hormone
Language	English
Publishing date	2005-02-02
Publishing country	United States
Document type	News
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.293.5.537
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Article ; Online: FDA approves ultrasound fibroid therapy.

Ringold, Sarah

JAMA

2004 Volume 292, Issue 23, Page(s) 2826

MeSH term(s)	Female ; Humans ; Leiomyoma/therapy ; Ultrasonic Therapy ; Uterine Neoplasms/therapy
Language	English
Publishing date	2004-12-15
Publishing country	United States
Document type	News
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.292.23.2826
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Article ; Online: The importance of rigorous methods in observational comparative effectiveness studies of rare diseases: comment on the article by Ruperto et al.

Kimura, Yukiko / Ong, Mei-Sing / Tomlinson, George / Ringold, Sarah / Schanberg, Laura E / Feldman, Brian M / Dennos, Anne / Del Gaizo, Vincent / Murphy, Katherine L / Natter, Marc

Arthritis & rheumatology (Hoboken, N.J.)

2022 Volume 74, Issue 5, Page(s) 912–913

MeSH term(s)	Humans ; Rare Diseases ; Research
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.42047
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