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104. Improved Quality of Life with Anti-TNF Therapy Compared to Continued Corticosteroid Utilization in Crohn’s Disease

Author

Scott, Frank I., primary, Reed Johnson, F., additional, Bewtra, Meenakshi, additional, Brensinger, Colleen M., additional, Roy, Jason A., additional, Reed, Shelby, additional, Osterman, Mark T., additional, Mamtani, Ronac, additional, Chen, Lang, additional, Yun, Huifeng, additional, Xie, Fenglong, additional, Curtis, Jeffrey R., additional, and Lewis, James D., additional

Published
2017
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105. Reduced Mortality Rates with Anti-Tumor Necrosis Factor Alpha Directed Therapy When Compared to Prolonged Corticosteroid Therapy for Inflammatory Bowel Disease

Author

Lewis, James D., primary, Scott, Frank I., additional, Brensinger, Colleen M., additional, Roy, Jason A., additional, Osterman, Mark T., additional, Mamtani, Ronac, additional, Chen, Lang, additional, Yun, Huifeng, additional, Xie, Fenglong, additional, and Curtis, Jeffrey R., additional

Published
2017
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106. Evaluation of the Effect of Diabetes on Rheumatoid Arthritis–related Outcomes in an Electronic Health Record–based Rheumatology Registry

Author

Yun, Huifeng, Xie, Fenglong, Chen, Lang, Yang, Shuo, Ferri, Leticia, Alemao, Evo, and Curtis, Jeffrey R.

Abstract

Objective.Patients with rheumatoid arthritis (RA) who also have diabetes mellitus (DM) might have worse clinical outcomes and adverse events compared to patients with RA who do not have DM. We evaluated the effects of DM on Health Assessment Questionnaire (HAQ) changes and outpatient infection rates in patients with RA.Methods.Using the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) electronic health record–based registry, we identified patients with RA who had ≥ 1 rheumatologist visit with a HAQ measured in 2016 (index visit), ≥ 1 previous visit, and a subsequent outcome visit with the same HAQ measured at 12 months (± 3 months). We identified DM by diagnosis codes, medications, or laboratory values. Outpatient infection was defined by diagnosis codes or antiinfective medications. We calculated mean HAQ change and incidence rate (IR) of outpatient infections among patients with and without DM. Generalized linear models and Cox regression were used to calculate the adjusted mean HAQ change and HRs.Results.We identified 3853 RA patients with DM and 18,487 without DM. The mean HAQ change between index and outcome visit among patients with DM was 0.03 and without DM was 0.002 (P< 0.01). We identified 761 outpatient infections for patients with DM with an IR of 22.6 (95% CI 21.0–24.2) per 100 person-years and 3239 among patients without DM with an IR of 19.8 (95% CI 19.1–20.5). The adjusted HR of outpatient infections among patients with DM was 0.99 (95% CI 0.91–1.07), compared to patients without DM.Conclusion.Patients with RA with concomitant DM had greater worsening, or less improvement, in their functional status, suggesting additional interventions may be needed for RA patients with DM to optimize treatment and management of other comorbidities.

Published
2021
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107. Benefits of Methotrexate Use on Cardiovascular Disease Risk Among Rheumatoid Arthritis Patients Initiating Biologic Disease-modifying Antirheumatic Drugs

Author

Xie, Fenglong, Chen, Lang, Yun, Huifeng, Levitan, Emily B., and Curtis, Jeffrey R.

Abstract

Objective.Methotrexate (MTX) has been associated with reduced risk for cardiovascular disease (CVD) events among patients with rheumatoid arthritis (RA) not exposed to biologic disease-modifying antirheumatic drugs (bDMARDs). The effect of concomitant MTX on CVD risk among RA patients initiating bDMARDs remains unknown.Methods.A retrospective cohort study was conducted to assess the effect of MTX on CVD risk using 2006–2015 Medicare claims data for patients with RA initiating bDMARD. The main exposure was current use of MTX, updated in a time-varying fashion. The primary outcome was a composite of incident myocardial infarction (MI), stroke, and fatal CVD. Secondary outcomes were each event that comprised the primary outcome. Incidence rates (IR) and 95% CI were calculated using Poisson regression. Associations between MTX and risk of CVD were assessed using Cox regression.Results.A total of 88,255 bDMARD initiations and 1861 CVD events were included in this study. Mean age was 64.6 (12.3) years, 84.0% were female, and 68.2% were non-Hispanic White. The crude IRs (95% CI) for CVD were 17.9 (16.9–18.8) and 12.1 (11.1–13.2) per 1000 patient-years among MTX unexposed and exposed, respectively. The multivariable adjusted HR (95% CI) for CVD events associated with MTX was 0.76 (0.68–0.85). Multivariable adjusted HRs were 0.78 (0.66–0.91), 0.74 (0.62–0.88), 0.77 (0.68–0.86), and 0.82 (0.73–0.93) for MI, stroke, MI or stroke, and a composite CVD outcome, respectively. Results were robust in sensitivity and subgroup analyses.Conclusion.Among patients with RA receiving biologics, concomitant MTX use was associated with a 24% lower risk for CVD events.

Published
2021
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109. Temporal Trends and Factors Associated with Bisphosphonate Discontinuation and Restart.

Author

Adami, Giovanni, Jaleel, Ayesha, Curtis, Jeffrey R, Delzell, Elizabeth, Chen, Rui, Yun, Huifeng, Daigle, Shanette, Arora, Tarun, Danila, Maria I, Wright, Nicole C, Cadarette, Suzanne M, Mudano, Amy, Foster, Jeffrey, and Saag, Kenneth G

Abstract

Adverse events related to long‐term use of bisphosphonates have raised interest in temporary drug discontinuation. Trends in bisphosphonate discontinuation and restart, as well factors associated with these decisions, are not fully understood at a population level. We investigated temporal trends of bisphosphonate discontinuation from 2010 to 2015 and identified factors associated with discontinuation and restart of osteoporosis therapy. Our cohort consisted of long‐term bisphosphonate users identified from 2010 to 2015 Medicare data. We defined discontinuation as ≥12 months without bisphosphonate prescription claims. We used conditional logistic regression to compare factors associated with alendronate discontinuation or osteoporosis therapy restart in the 120‐day period preceding discontinuation or restart referent to the 120‐day preceding control periods. Among 73,800 long‐term bisphosphonate users, 59,251 (80.3%) used alendronate, 6806 (9.2%) risedronate, and 7743 (10.5%) zoledronic acid, exclusively. Overall, 26,281 (35.6%) discontinued bisphosphonates for at least 12 months. Discontinuation of bisphosphonates increased from 1.7% in 2010, reaching a peak of 14% in 2012 with levels plateauing through 2015. The factors most strongly associated with discontinuation of alendronate were: benzodiazepine prescription (adjusted odds ratio [aOR] = 2.5; 95% confidence interval [CI] 2.1, 3.0), having a dual‐energy X‐ray absorptiometry (DXA) scan (aOR = 1.8; 95% CI 1.7, 2.0), and skilled nursing facility care utilization (aOR = 1.8; 95% CI 1.6, 2.1). The factors most strongly associated with restart of osteoporosis therapy were: having a DXA scan (aOR = 9.9; 95% CI 7.7, 12.6), sustaining a fragility fracture (aOR = 2.8; 95% CI 1.8, 4.5), and an osteoporosis or osteopenia diagnosis (aOR = 2.5; 95% CI 2.0, 3.1). Our national evaluation of bisphosphonate discontinuation showed that an increasing proportion of patients on long‐term bisphosphonate therapy discontinue medications. The factors associated with discontinuation of alendronate were primarily related to worsening of overall health status, whereas traditional factors associated with worsening bone health were associated with restarting osteoporosis medication. © 2019 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Published
2020
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115. Association Between Breast Cancer Recurrence and Immunosuppression in Rheumatoid Arthritis and Inflammatory Bowel Disease: A Cohort Study

Author

Mamtani, Ronac, primary, Clark, Amy S., additional, Scott, Frank I., additional, Brensinger, Colleen M., additional, Boursi, Ben, additional, Chen, Lang, additional, Xie, Fenglong, additional, Yun, Huifeng, additional, Osterman, Mark T., additional, Curtis, Jeffrey R., additional, and Lewis, James D., additional

Published
2016
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120. Perspectives of Rheumatoid Arthritis Patients on Electronic Communication and Patient-Reported Outcome Data Collection: A Qualitative Study.

Author

Navarro‐Millán, Iris, Zinski, Anne, Shurbaji, Sally, Johnson, Bernadette, Fraenkel, Liana, Willig, James, Danila, Maria I., Yun, Huifeng, Curtis, Jeffrey R., Safford, Monika M., and Navarro-Millán, Iris

Subjects
RHEUMATOID arthritis diagnosis, COMMUNICATION, COMPARATIVE studies, FOCUS groups, RESEARCH methodology, MEDICAL cooperation, RESEARCH, RHEUMATOID arthritis, TELEMEDICINE, QUALITATIVE research, EVALUATION research, ACQUISITION of data, STANDARDS
Abstract

Objective: To identify the perspectives of patients with rheumatoid arthritis (RA) on electronic recording of between-visit disease activity and other patient-reported outcomes (PROs) and on sharing this information with health care providers or peers.Methods: Patients with RA were recruited to participate in focus groups from December 2014 to April 2015. The topic guide and analysis were based on the Andersen-Newman framework. Sessions were audiorecorded, transcribed, independently coded, and analyzed for themes.Results: Thirty-one patients participated in 7 focus groups. Their mean ± SD age was 51 ± 13.1 years, 94% were women, 52% were African American, 11% were Hispanic, and 37% were white. Three themes emerged: provider communication, information-seeking about RA, and social and peer support. Participants expressed a willingness to track disease activity data to share with health care providers electronically if providers would act on the information. Participants envisioned symptom tracking and information sharing as a mechanism to relay and obtain reliable information about RA. Participants were also interested in electronic communication between visits if it facilitated learning about symptom management and enhanced opportunities for social support among patients with RA.Conclusion: Patients with RA may be amenable to electronic collection and sharing of PRO-type data between clinical encounters if it facilitates communication with health care providers and provides access to reliable information about RA. Providing patients with social support was important for enhancing PROs collection by helping them overcome barriers by using electronic devices and overcome reservations about the value of these data. [ABSTRACT FROM AUTHOR]

Published
2019
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121. Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis

Author

Zhang, Jie, primary, Xie, Fenglong, additional, Yun, Huifeng, additional, Chen, Lang, additional, Muntner, Paul, additional, Levitan, Emily B, additional, Safford, Monika M, additional, Kent, Shia T, additional, Osterman, Mark T, additional, Lewis, James D, additional, Saag, Kenneth, additional, Singh, Jasvinder A, additional, and Curtis, Jeffrey R, additional

Published
2016
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122. Comparative Risk of Hospitalized Infection Associated With Biologic Agents in Rheumatoid Arthritis Patients Enrolled in Medicare

Author

Yun, Huifeng, primary, Xie, Fenglong, additional, Delzell, Elizabeth, additional, Levitan, Emily B., additional, Chen, Lang, additional, Lewis, James D., additional, Saag, Kenneth G., additional, Beukelman, Timothy, additional, Winthrop, Kevin L., additional, Baddley, John W., additional, and Curtis, Jeffrey R., additional

Published
2015
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123. Reply

Author

Yun, Huifeng, primary, Badley, John W., additional, Curtis, Jeffrey R., additional, and Winthrop, Kevin, additional

Published
2015
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129. Biomarker-related risk for myocardial infarction and serious infections in patients with rheumatoid arthritis: a population-based study.

Author

Curtis, Jeffrey R., Fenglong Xie, Lang Chen, Saag, Kenneth G., Huifeng Yun, Muntner, Paul, Xie, Fenglong, Chen, Lang, and Yun, Huifeng

Subjects
COMPARATIVE studies, CORONARY disease, HOSPITAL care, LONGITUDINAL method, RESEARCH methodology, MEDICAL cooperation, MYOCARDIAL infarction, RESEARCH, RHEUMATOID arthritis, RISK assessment, SEPSIS, EVALUATION research, SEVERITY of illness index, DISEASE progression, DISEASE complications
Abstract

Background: Rheumatoid arthritis (RA) disease activity and associated systemic inflammation has been associated with serious infection (SIEs), myocardial infarction (MI) and coronary heart disease (CHD) events based on a few registry studies or clinical trials. There are few data from large-scale population-based studies given feasibility challenges in conducting such investigations.Methods: Multibiomarker disease activity (MBDA) test scores (n=77 641) were linked to Medicare for US patients with RA. Outcomes of interest were hospitalised pneumonia/sepsis (SIE), MI and a composite CHD outcome. The MBDA score ranges from 1 to 100 and was analysed as time-varying. Cox proportional hazards models evaluated the association between MBDA score and SIEs, MI and CHD events, controlling for potential confounders. A sensitivity analysis excluded C reactive protein (CRP) from the MBDA score.Results: There were 17 433 and 16 796 patients eligible for the SIE and MI/CHD analyses, respectively. Mean (SD) age was 69 (11) years, 79% were women, 81% were white and 38% were disabled. Over 16 424 person-years of follow-up, there were 452 SIE events, 132 MIs and 181 CHD events. Higher MBDA scores were associated with SIEs (HR=1.32, 95% CI 1.23 to 1.41 per 10 unit MBDA score change). For MI/CHD events, a threshold effect was present; higher disease activity by MBDA score was associated with increased MI (HR=1.52, 95% CI 0.92 to 2.49) and CHD rates (HR=1.54, 95% CI 1.01 to 2.34, comparing scores ≥30 vs <30). Analyses of the MBDA score without CRP yielded similar results.Conclusion: Higher MBDA scores were associated with hospitalised infection, MI and CHD events in a large, predominantly older, US RA population. [ABSTRACT FROM AUTHOR]

Published
2018
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131. Statin Use Following Hospitalization Among Medicare Beneficiaries With a Secondary Discharge Diagnosis of Acute Myocardial Infarction

Author

Yun, Huifeng, primary, Safford, Monika M., additional, Brown, Todd M., additional, Farkouh, Michael E., additional, Kent, Shia, additional, Sharma, Pradeep, additional, Kilgore, Meredith, additional, Bittner, Vera, additional, Rosenson, Robert S., additional, Delzell, Elizabeth, additional, Muntner, Paul, additional, and Levitan, Emily B., additional

Published
2015
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134. Linkage of a De-Identified United States Rheumatoid Arthritis Registry With Administrative Data to Facilitate Comparative Effectiveness Research

Author

Curtis, Jeffrey R., primary, Chen, Lang, additional, Bharat, Aseem, additional, Delzell, Elizabeth, additional, Greenberg, Jeffrey D., additional, Harrold, Leslie, additional, Kremer, Joel, additional, Setoguchi, Soko, additional, Solomon, Daniel H., additional, Xie, Fenglong, additional, and Yun, Huifeng, additional

Published
2014
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136. Ability of Low Antihypertensive Medication Adherence to Predict Statin Discontinuation and Low Statin Adherence in Patients Initiating Treatment After a Coronary Event

Author

Muntner, Paul, primary, Yun, Huifeng, additional, Sharma, Pradeep, additional, Delzell, Elizabeth, additional, Kent, Shia T., additional, Kilgore, Meredith L., additional, Farkouh, Michael E., additional, Vupputuri, Suma, additional, Bittner, Vera, additional, Rosenson, Robert S., additional, Levitan, Emily B., additional, and Safford, Monika M., additional

Published
2014
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137. Declines in coronary heart disease incidence and mortality among middle-aged adults with and without diabetes

Author

Carson, April P., primary, Tanner, Rikki M., additional, Yun, Huifeng, additional, Glasser, Stephen P., additional, Woolley, J. Michael, additional, Thacker, Evan L., additional, Levitan, Emily B., additional, Farkouh, Michael E., additional, Rosenson, Robert S., additional, Brown, Todd M., additional, Howard, George, additional, Safford, Monika M., additional, and Muntner, Paul, additional

Published
2014
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142. Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy

Author

Yun, Huifeng, primary, Xie, Fenglong, additional, Delzell, Elizabeth, additional, Chen, Lang, additional, Levitan, Emily B, additional, Lewis, James D, additional, Saag, Kenneth G, additional, Beukelman, Timothy, additional, Winthrop, Kevin, additional, Baddley, John W, additional, and Curtis, Jeffrey R, additional

Published
2014
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148. Trends in the Prevalence, Awareness, Treatment and Control of High Low Density Lipoprotein-Cholesterol Among United States Adults From 1999–2000 Through 2009–2010

Author

Muntner, Paul, primary, Levitan, Emily B., additional, Brown, Todd M., additional, Sharma, Pradeep, additional, Zhao, Hong, additional, Bittner, Vera, additional, Glasser, Stephen, additional, Kilgore, Meredith, additional, Yun, Huifeng, additional, Woolley, J. Michael, additional, Farkouh, Michael E., additional, and Rosenson, Robert S., additional

Published
2013
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149. Death, Debility, and Destitution Following Hip Fracture

Author

Tajeu, Gabriel S., primary, Delzell, Elizabeth, additional, Smith, Wilson, additional, Arora, Tarun, additional, Curtis, Jeffrey R., additional, Saag, Kenneth G., additional, Morrisey, Michael A., additional, Yun, Huifeng, additional, and Kilgore, Meredith L., additional

Published
2013
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