A5025043247- Systemic Lupus Erythematosus Research
- Pregnancy and Medication Impact
- Reproductive System and Pregnancy
- Pregnancy and preeclampsia studies
- Atherosclerosis and Cardiovascular Diseases
- Rheumatoid Arthritis Research and Therapies
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Endometriosis Research and Treatment
- Pharmacological Effects of Natural Compounds
- Immunodeficiency and Autoimmune Disorders
- Diabetes and associated disorders
- Eosinophilic Esophagitis
- Blood groups and transfusion
- Peripheral Neuropathies and Disorders
- SARS-CoV-2 and COVID-19 Research
- Reproductive Health and Contraception
- Autoimmune and Inflammatory Disorders Research
- Systemic Sclerosis and Related Diseases
- Complement system in diseases
- Hematopoietic Stem Cell Transplantation
- Renal Diseases and Glomerulopathies
- Medication Adherence and Compliance
- COVID-19 Clinical Research Studies
- Vasculitis and related conditions
- Liver Diseases and Immunity
Duke University
2017-2025
Duke Medical Center
2016-2025
Duke University Hospital
2018-2025
University of North Carolina at Chapel Hill
2014-2023
Center for Rheumatology
2023
Durham VA Medical Center
2023
Emory University
2023
American College of Rheumatology
2023
Rheumatology Consultants
2023
eLearning Studios (United Kingdom)
2023
Objective To develop an evidence‐based guideline on contraception, assisted reproductive technologies ( ART ), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy HRT pregnancy assessment and management, medication in patients rheumatic musculoskeletal disease RMD ). Methods We conducted a systematic review evidence relating to , preservation, lactation, populations, using Grading Recommendations Assessment, Development Evaluation methodology rate...
Objective To develop an evidence‐based guideline on contraception, assisted reproductive technologies ( ART ), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy HRT pregnancy assessment and management, medication in patients rheumatic musculoskeletal disease RMD ). Methods We conducted a systematic review evidence relating to , preservation, lactation, populations, using Grading Recommendations Assessment, Development Evaluation methodology rate...
<h3>Objective</h3> Prior studies found conflicting results about whether lupus is likely to flare during or after pregnancy. Using a large cohort of pregnant and non-pregnant women with lupus, we estimated the effect pregnancy on disease flares in systemic erythematosus. <h3>Methods</h3> Data were collected Hopkins Lupus Cohort 1987–2015. Women aged 14–45 years >1 measurement activity included. The time-varying exposures classified as pregnancy, postpartum non-pregnant/non-postpartum...
Some sources urge caution when prescribing hydroxychloroquine (HCQ) to patients with G6PDH deficiency, presumably due a risk of hemolytic anemia. There are limited published data, however, support this risk. Additionally, not all deficiency at similar for hemolysis, and people the African variant particularly low Through retrospective chart review, we aimed quantify frequency G6PDH-deficient hemolysis attributed HCQ.We identified Duke University Medical Center rheumatology HCQ use measured...
To survey an international sample of providers to determine their current practices for the prevention, screening, and treatment congenital heart block (CHB) due maternal Ro/SSA antibodies.A was designed by organizing committee 9th International Conference Reproduction, Pregnancy Rheumatic Diseases. It sent attendants conference authors recent publications or abstracts at ACR 2012, 2013 2014 on rheumatic diseases pregnancy.In anti-Ro/SSA positive women, 80% 49 respondents recommended...
Objective In the new Type 1 & 2 model for systemic lupus erythematosus (SLE), SLE represents classic inflammatory manifestations, such as arthritis, while encompasses symptoms pain and fatigue where relationship to inflammation is less clear. The objective of this study was interview individuals living with determine content face validity model. Methods We conducted a qualitative using semi-structured interviews purposeful sample participants who met classification criteria SLE....
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Restrictions in community mobility, defined as the frequency of and help required to travel 'life-spaces' (bedroom, home, yard, neighbourhood town), are associated with poor outcomes among older adults. We aimed describe explore factors mobility adults SLE. assessed cross-sectionally a population-based SLE cohort (October 2019 May 2022), using University Alabama Birmingham Study Aging Life-Space Assessment (UAB LSA) (score range, 0-120; higher scores=greater mobility). Community was...
Objective In seeking new approaches to improve lupus pregnancy outcomes, we study the association between planning, behaviors recommended by American College of Rheumatology’s Reproductive Health Guideline 2020, and infant outcomes. Methods Lupus pregnancies in a prospective registry (1/1/2018 4/1/2020) were classified as planned or not-planned using patient-reported London Measure Unplanned Pregnancy. These groups compared for demographics, pre-pregnancy disease activity, planning...
Kidney function is not routinely assessed during pregnancy. Several studies have proposed antepartum kidney function, particularly 2nd trimester as a potential predictor of adverse pregnancy outcomes. It has been previously established that patients with Systemic Lupus Erythematosus are at increased risk for The association between and outcomes evaluated in diverse patient populations, among high obstetrical risk. In this observational study pregnant lupus North America Europe from...
Objective. Pregnancies in women with active rheumatic disease often result poor neonatal outcomes. Hydroxychloroquine (HCQ) reduces activity and flares; however, pregnancy causes significant physiologic changes that may alter HCQ levels lead to therapeutic failure. Therefore, our objective was evaluate concentrations during relate Methods. We performed an observational study of pregnant patients who were taking from a single center 2013–2016. Serum samples analyzed using high-performance...
The type 1 and 2 systemic lupus erythematosus (SLE) categorization system was recently proposed to validate the patients' perspective of disease capture a more comprehensive spectrum symptoms. objective this study characterize clinical manifestations SLE subtypes determine correlation between patient- physician-reported measures used in model.This cross-sectional patients with university clinic. Patients completed Systemic Lupus Activity Questionnaire (SLAQ) 2011 American College...
Objective Evaluate the impact of pregnancy physiology and medication non-adherence on serum hydroxychloroquine (HCQ) pharmacokinetics (PK) exposure-response in SLE. Methods We conducted a PK analysis using data from two observational registries. enrolled pregnant women with SLE taking HCQ at least 3 months prior to, throughout pregnancy, excluded those multiple gestations. Using model, we dosing simulations imputed 0%/20%/40%/60% to evaluate adherence versus physiological changes...
We evaluated the association of lupus nephritis (LN) and adverse pregnancy outcomes in prospective cohorts pregnant women with SLE (systemic erythematosus).
We have developed a new conceptual model to characterise the signs and symptoms of SLE: Type 1 2 SLE Model. Within original model, consists inflammatory manifestations like arthritis, nephritis rashes; includes fatigue, myalgia, mood disturbance cognitive dysfunction. Through in-depth interviews, we explored how Model fits within lived experience patients with SLE, focus on connection between symptoms.Semistructured interviews were conducted among adult participants meeting 1997 American...
Medication nonadherence is more common in African Americans compared with Caucasians. We examined the racial adherence gaps among patients systemic lupus erythematosus (SLE) and explored factors associated nonadherence.Cross-sectional data were obtained from consecutive prescribed SLE medications seen at an academic clinic between August 2018 February 2019. Adherence was measured using both self-report pharmacy refill data. High composite defined as having high self-reported rates....
Objective To assess the impact of mild-moderate systemic lupus erythematosus (SLE) disease activity during a 12-month period on risk death or subsequent organ system damage. Methods 1168 patients with ≥24 months follow-up from Hopkins Lupus Cohort were included. Disease in observation was calculated using adjusted mean Safety Estrogens Erythematosus National Assessment (SELENA) version SLE Activity Index (SLEDAI), defined as area under curve divided by time interval. Damage accrual change...
Objective To determine reasons for cesarean and medically indicated deliveries in a registry of pregnant women with SLE compared to RA. Methods Pregnant or RA were prospectively followed, pregnancy outcomes collected, including whether labor was spontaneous delivery vaginal cesarean. Preterm birth defined as <37 weeks gestation. Differences indication between term preterm births determined by Fisher’s exact test. Results Compared pregnancies, pregnancies had modestly higher rates (24% vs...
While increased rheumatic disease activity during pregnancy has been associated with adverse outcomes, this is typically assessed by physicians. Little known, however, about the association between patient-reported measures of and outcomes. The aim our study was to evaluate association.Univariate multivariable regression models were used assess relationship patient- physician-reported outcomes in 225 patients systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). enrolled from...
Objective. To characterize hydroxychloroquine (HCQ) exposure in patients with rheumatic disease receiving longterm HCQ compared to target concentrations reported antiviral activity against the coronavirus 2019 caused by SARS-CoV-2 (COVID-19). Method. We evaluated total serum and plasma from published literature values, frozen samples a pediatric systemic lupus erythematosus trial, simulated using pharmacokinetic model during pregnancy. For each source, we observed or predicted SARS-CoV-2....
Objective Characterise the relationship between hydroxychloroquine (HCQ) blood levels and number of missed doses, accounting for dosage, dose timing large variability in pharmacokinetics (PK) patients. Methods We externally validated a published PK model then conducted dosing simulations. developed virtual population 1000 patients each dosage across range body weights variability. Using model, 10 Monte Carlo simulations patient were to derive predicted whole concentrations every hour over 24...