Browsing by Author "Gbadegesin, Rasheed"

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    Adrenocorticotropic Hormone for Childhood Nephrotic Syndrome: The ATLANTIS Randomized Trial
    (American Society of Nephrology, 2018-12-07) Wang, Chia-shi; Travers, Curtis; McCracken, Courtney; Leong, Traci; Gbadegesin, Rasheed; Quiroga, Alejandro; Benfield, Mark R.; Hidalgo, Guillermo; Srivastava, Tarak; Lo, Megan; Yadin, Ora; Mathias, Robert; Araya, Carlos E.; Khalid, Myda; Orjuela, Alvaro; Zaritsky, Joshua; Al-Akash, Samhar; Kamel, Margret; Greenbaum, Larry A.; Pediatrics, School of Medicine
    Background and objectives There is renewed interest in adrenocorticotropic hormone (ACTH) for the treatment of nephrotic syndrome. We evaluated the efficacy and safety of ACTH in children with frequently relapsing or steroid-dependent nephrotic syndrome in a randomized trial. Design, setting, participants, & measurements Participants aged 2–20 years old with frequently relapsing or steroid-dependent nephrotic syndrome were enrolled from 16 sites in the United States and randomized 1:1 to ACTH (repository corticotropin injection) or no relapse-preventing treatment. ACTH treatment regimen was 80 U/1.73 m2 administered twice weekly for 6 months, followed by 40 U/1.73 m2 administered twice weekly for 6 months. The primary outcome was disease relapse during the first 6 months. Participants in the control group were offered crossover to ACTH treatment if they relapsed within 6 months. Secondary outcomes were relapse after ACTH dose reduction and treatment side effects. Results The trial was stopped at a preplanned interim analysis after enrollment of 31 participants because of a lack of discernible treatment efficacy. Fourteen out of 15 (93%) participants in the ACTH arm experienced disease relapse in the first 6 months, with a median time to first relapse of 23 days (interquartile range, 9–32), compared with 15 out of 16 (94%) participants and at a median of 21 days (interquartile range, 14–51) in the control group. There was no difference in the proportion of relapsed patients (odds ratio, 0.93; 95% confidence interval, 0.05 to 16.40; P>0.99) or time to first relapse (hazard ratio, 1.03; 95% confidence interval, 0.50 to 2.15; P=0.93). Thirteen out of 16 participants in the control group crossed over to ACTH treatment. Three out of 28 participants completed 12 months of ACTH treatment; the others exited the trial because of frequent relapses or side effects. There were no disease relapses after ACTH dose reduction among the three participants. Most side effects were mild and similar to side effects of corticosteroids. Conclusions ACTH at 80 U/1.73 m2 administered twice weekly was ineffective at preventing disease relapses in pediatric nephrotic syndrome.
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    Doris Duke Charitable Foundation Fund to Retain Clinical Scientists: innovating support for early-career family caregivers
    (American Society for Clinical Investigation, 2022-12-01) Jagsi, Reshma; Beeland, T. DeLene; Sia, Kevin; Szczygiel, Lauren A.; Allen, Matthew R.; Arora, Vineet M.; Bair-Merritt, Megan; Bauman, Melissa D.; Bogner, Hillary R.; Daumit, Gail; Davis, Esa; Fagerlin, Angela; Ford, Daniel E.; Gbadegesin, Rasheed; Griendling, Kathy; Hartmann, Katherine; Hedayati, S. Susan; Jackson, Rebecca D.; Matulevicius, Susan; Mugavero, Michael J.; Nehl, Eric J.; Neogi, Tuhina; Regensteiner, Judith G.; Rubin, Michael A.; Rubio, Doris; Singer, Kanakadurga; Tucker Edmonds, Brownsyne; Volerman, Anna; Laney, Sandra; Patton, Carrie; Escobar Alvarez, Sindy; Anatomy, Cell Biology and Physiology, School of Medicine
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    Racial and Ethnic Disparities in Acute Care Utilization Among Patients With Glomerular Disease
    (Elsevier, 2023) Krissberg, Jill R.; O’Shaughnessy, Michelle M.; Smith, Abigail R.; Helmuth, Margaret E.; Almaani, Salem; Aviles, Diego H.; Brathwaite, Kaye E.; Cai, Yi; Cattran, Daniel; Gbadegesin, Rasheed; Glenn, Dorey A.; Greenbaum, Larry A.; Iragorri, Sandra; Jain, Koyal; Khalid, Myda; Kidd, Jason; Kopp, Jeffrey; Lafayette, Richard; Lane, Jerome C.; Lugani, Francesca; Nestor, Jordan G.; Parekh, Rulan S.; Reidy, Kimberly; Selewski, David T.; Sethna, Christine B.; Sperati, C. John; Tuttle, Katherine; Twombley, Katherine; Vasylyeva, Tetyana L.; Weaver, Donald J., Jr.; Wenderfer, Scott E.; Gibson, Keisha; CureGN Consortium; Pediatrics, School of Medicine
    Rationale & objective: The effects of race, ethnicity, socioeconomic status (SES), and disease severity on acute care utilization in patients with glomerular disease are unknown. Study design: Prospective cohort study. Setting & participants: 1,456 adults and 768 children with biopsy-proven glomerular disease enrolled in the Cure Glomerulonephropathy (CureGN) cohort. Exposure: Race and ethnicity as a participant-reported social factor. Outcome: Acute care utilization defined as hospitalizations or emergency department visits. Analytical approach: Multivariable recurrent event proportional rate models were used to estimate associations between race and ethnicity and acute care utilization. Results: Black or Hispanic participants had lower SES and more severe glomerular disease than White or Asian participants. Acute care utilization rates were 45.6, 29.5, 25.8, and 19.2 per 100 person-years in Black, Hispanic, White, and Asian adults, respectively, and 55.8, 42.5, 40.8, and 13.0, respectively, for children. Compared with the White race (reference group), Black race was significantly associated with acute care utilization in adults (rate ratio [RR], 1.76 [95% CI, 1.37-2.27]), although this finding was attenuated after multivariable adjustment (RR, 1.31 [95% CI, 1.03-1.68]). Black race was not significantly associated with acute care utilization in children; Asian race was significantly associated with lower acute care utilization in children (RR, 0.32 [95% CI 0.14-0.70]); no significant associations between Hispanic ethnicity and acute care utilization were identified. Limitations: We used proxies for SES and lacked direct information on income, household unemployment, or disability. Conclusions: Significant differences in acute care utilization rates were observed across racial and ethnic groups in persons with prevalent glomerular disease, although many of these difference were explained by differences in SES and disease severity. Measures to combat socioeconomic disadvantage in Black patients and to more effectively prevent and treat glomerular disease are needed to reduce disparities in acute care utilization, improve patient wellbeing, and reduce health care costs.