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Hui-Yuen JS, Reddy A, Taylor J, Li X, Eichenfield AH, Bermudez LM, Starr AJ, Imundo LF, Buyon J, Furie RA, Kamen DL, Manzi S, Petri M, Ramsey-Goldman R, van Vollenhoven RF, Wallace DJ, Askanase A. Safety and Efficacy of Belimumab to Treat Systemic Lupus Erythematosus in Academic Clinical Practices. J Rheumatol 2015; 42:2288-95. [PMID: 26523030 DOI: 10.3899/jrheum.150470] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the use and efficacy of belimumab in academic practices. Belimumab is a human monoclonal antibody that inhibits soluble B lymphocyte stimulator and has been approved for the treatment of adults with systemic lupus erythematosus (SLE). METHODS Invitations to participate and complete a 1-page questionnaire for each patient prescribed belimumab were sent to 16 physicians experienced in SLE phase III clinical trials. The outcome was defined as the physician's impression of improvement in the initial manifestation(s) being treated without worsening in other organ systems. RESULTS Of 195 patients treated with belimumab at 10 academic centers, 96% were taking background medications for SLE at initiation of belimumab, with 74% taking corticosteroids. The main indications for initiation of belimumab were arthritis, rash, and/or worsening serologic activity, with 30% of patients unable to taper corticosteroids. Of the 120 patients taking belimumab for at least 6 months, 51% responded clinically and 67% had ≥ 25% improvement in laboratory values. While numbers are limited, black patients showed improvement at 6 months. In a subset of 39 patients with childhood-onset SLE, 65% responded favorably at 6 months, and 35% discontinued corticosteroids. CONCLUSION Our data demonstrate favorable clinical and laboratory outcomes in patients with SLE at 6 months across all racial and ethnic groups, with similar improvement seen among patients with childhood-onset SLE.
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Affiliation(s)
- Joyce S Hui-Yuen
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Arthi Reddy
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Jennifer Taylor
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Xiaoqing Li
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Andrew H Eichenfield
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Liza M Bermudez
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Amy J Starr
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Lisa F Imundo
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Jill Buyon
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Richard A Furie
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Diane L Kamen
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Susan Manzi
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Michelle Petri
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Rosalind Ramsey-Goldman
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Ronald F van Vollenhoven
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Daniel J Wallace
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
| | - Anca Askanase
- From the Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; New York University Langone Medical Center; Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center, New York; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York; Medical University of South Carolina, Charleston, South Carolina; Temple University School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Karolinska University Hospital, Stockholm, Sweden; Cedars-Sinai Medical Center, Los Angeles, California, USA.J.S. Hui-Yuen, MD, MSc, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A. Reddy, BSc, Research Assistant, New York University Langone Medical Center; J. Taylor, MD, Pediatric Resident, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; X. Li, BSc, Research Assistant, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; A.H. Eichenfield, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.M. Bermudez, MD, Fellow, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; A.J. Starr, MD, Assistant Professor, Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital of New York-Presbyterian Hospital/Columbia University Medical Center; L.F. Imundo, MD, Division of Rheumatology, New York-Presbyterian Hospital/Columbia University Medical Center; J. Buyon, MD, Professor, New York University Langone Medical
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