Browsing by Author "Huang, Bin"

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    Biomarker Changes in Response to Tofacitinib Treatment in Patients With Polyarticular-Course Juvenile Idiopathic Arthritis
    (Wiley, 2024) Ogbu, Ekemini A.; Brunner, Hermine I.; Eloseily, Esraa; Aviel, Yonatan Butbul; Nanda, Kabita; Schmeling, Heinrike; Tory, Heather; Uziel, Yosef; Viola, Diego Oscar; Wahezi, Dawn M.; Tarvin, Stacey E.; Sproles, Alyssa; Chen, Chen; Ruperto, Nicolino; Huang, Bin; Grom, Alexei; Thornton, Sherry; Investigators of the PRINTO and PRCSG Networks; Pediatrics, School of Medicine
    Objective: We examine levels of candidate blood-based biomarkers (CBBs) in patients with juvenile idiopathic arthritis (JIA) treated with tofacitinib. Methods: Patients with JIA who participated in clinical trial NCT02592434 received tofacitinib from baseline to week 18. Serial serum samples were assayed for CBBs (S100A8/9, S100A12, interleukin-18 [IL-18], serum amyloid A, resistin, vascular endothelial growth factor, angiopoietin-1, angiopoietin-2, matrix metalloproteinase 8 [MMP8], MMP2, tissue inhibitor of metalloproteinases 1, leptin, chemokine [C-X-C motif] ligand 9, soluble IL-2 receptor, intercellular adhesion molecule 1, soluble tumor necrosis factor receptor, IL-6, IL-23, monocyte chemotactic protein 1, chemokine [C-C motif] ligand 18 [CCL18], and CCL20). Association of CBBs with JIA response to treatment from baseline to week 18 were assessed. Results: This study included 166 patients with polyarticular-course JIA. Paired serum samples from 143 patients were available at both baseline and week 18. Thirty-five percent (50 of 143) of patients had a JIA-American College of Rheumatology 90 (JIA-ACR90) level improvement, whereas 90, 121, and 137 (63%, 85%, and 96%) achieved JIA-ACR70, 50, and 30 improvement at week 18. Despite small numerical differences by JIA category, there were no baseline CBB values that independently predicted a decrease in Juvenile Arthritis Disease Activity Score (JADAS-27) or JIA-ACR90 response by week 18. Decrease in resistin level (baseline to week 18) was significantly associated with week 18 improvement in JADAS-27 and JIA-ACR90 response after adjusting for age, sex, JIA disease duration, and baseline resistin (r2 0.79, SE 0.070, P < 0.01, and odds ratio [95% confidence interval] 1.134 [1.018-1.264]). HLA-B27 positivity was significantly associated with not achieving a JIA-ACR90 response at week 18 (P = 0.0097). Conclusion: Among the CBBs included, only resistin was significantly associated with treatment response, and no CBB was identified that forecasts JIA improvement after initiation of tofacitinib. The association of HLA-B27 positivity with lower response to tofacitinib in JIA is intriguing and merits further study.
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    Feasibility of Conducting Comparative Effectiveness Research and Validation of a Clinical Disease Activity Score for Chronic Nonbacterial Osteomyelitis
    (The Journal of Rheumatology, 2023) Wu, Eveline Y.; Oliver, Melissa; Scheck, Joshua; Lapidus, Sivia; Akca, Ummusen Kaya; Yasin, Shima; Stern, Sara M.; Insalaco, Antonella; Pardeo, Manuela; Simonini, Gabriele; Marrani, Edoardo; Wang, Xing; Huang, Bin; Kovalick, Leonard K.; Rosenwasser, Natalie; Casselman, Gabriel; Liau, Adriel; Shao, Yurong; Yang, Claire; Mosa, Doaa Mosad; Tucker, Lori; Girschick, Hermann; Laxer, Ronald M.; Akikusa, Jonathan D.; Hedrich, Christian; Onel, Karen; Dedeoglu, Fatma; Twilt, Marinka; Ferguson, Polly J.; Ozen, Seza; Zhao, Yongdong; Pediatrics, School of Medicine
    Objective: Prospective comparative effectiveness research (CER) in chronic nonbacterial osteomyelitis (CNO) is lacking. Our objectives were to (1) determine the use and safety of each consensus treatment plan (CTP) regimen for CNO, (2) assess the feasibility of using the Chronic Nonbacterial Osteomyelitis International Registry (CHOIR) data for CER, and (3) develop and validate a CNO clinical disease activity score (CDAS) using CHOIR. Methods: Consenting children or young adults with CNO were enrolled into CHOIR. Demographic, clinical, and imaging data were prospectively collected. The CNO CDAS was developed through a Delphi survey and nominal group technique. External validation surveys were administered to CHOIR participants. Results: One hundred forty (78.2%) CHOIR participants enrolled between August 2018 and September 2020 received at least 1 CTP regimen. Baseline characteristics from different CTP groups were well matched. Patient pain, patient global assessment, and clinical CNO lesion count were key variables included in the CNO CDAS. The CDAS showed a strong correlation with patient/parent report of difficulty using a limb, back, or jaw and patient/parent report of disease severity, but a weak correlation with patient/parent report of fatigue, sadness, and worry. The change in CDAS was significant in patients reporting disease worsening or improvement (P < 0.001). The CDAS significantly decreased after initiating second-line treatments from median 12.0 (IQR 8.0-15.5) to 5.0 (IQR 3.0-12.0; P = 0.002). Although second-line treatments were well tolerated, psoriasis was the most common adverse event. Conclusion: The CNO CDAS was developed and validated for disease monitoring and assessment of treatment effectiveness. CHOIR provided a comprehensive framework for future CER.
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    Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women
    (Elsevier, 2016-07-25) Kowalczyk Mullins, Tanya L.; Zimet, Gregory D.; Rosenthal, Susan L.; Morrow, Charlene; Ding, Lili; Huang, Bin; Kahn, Jessica A.; Pediatrics, School of Medicine
    OBJECTIVE: To examine the association between risk perceptions after human papillomavirus (HPV) vaccination and sexual behaviors and sexually transmitted infection (STI) diagnosis over 30months following vaccination. METHODS: Participants included 112 sexually experienced girls aged 13-21years who were enrolled at the time of first HPV vaccination and completed ⩾2 of 4 follow-up visits at 2, 6, 18, 30months and including 30months. At each visit, participants completed surveys assessing risk perceptions (perceived need for safer sexual behaviors, perceived risk of STIs other than HPV) and sexual behaviors. STI testing was done at 6, 18, and 30months. Outcomes were condom use at last intercourse with main male partner, number of sexual partners since last study visit, and STI diagnosis. Associations between risk perceptions and sexual behaviors/STIs were examined using generalized linear mixed models. RESULTS: Mean age was 17.9years; 88% were Black; 49% had a history of STI at baseline. Scale scores for perceived need for safer sexual behaviors did not change significantly over time. Scale scores for perceived risk of STIs other than HPV significantly changed (p=0.027), indicating that girls perceived themselves to be more at risk of STIs other than HPV over 30months following vaccination. Multivariable models demonstrated that greater perceived need for safer sexual behaviors following vaccination was associated with condom use (p=0.002) but not with number of partners or STI diagnosis. Perceived risk of STIs other than HPV was not associated with the three outcomes. CONCLUSIONS: The finding that perceived risk for STIs other than HPV was not associated with subsequent sexual behaviors or STI diagnosis is reassuring. The association between perceived need for safer sexual behaviors and subsequent condom use suggests that the HPV vaccination visit is an important opportunity to reiterate the importance of safer sexual behaviors to sexually experienced girls.
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    Human Papillomavirus Vaccine-Related Risk Perceptions Do Not Predict Sexual Initiation Among Young Women Over 30 Months Following Vaccination
    (Elsevier, 2018-02) Mullins, Tanya L. Kowalczyk; Rosenthal, Susan L.; Zimet, Gregory D.; Ding, Lili; Morrow, Charlene; Huang, Bin; Kahn, Jessica A.; School of Nursing
    PURPOSE: We examined longitudinally the relationship between human papillomavirus (HPV) vaccine-related risk perceptions and initiation of sexual activity among adolescent women over 30 months after HPV vaccination. METHODS: Participants included 91 sexually inexperienced women aged 13-21 years receiving the HPV vaccine who completed at least three of five study visits. At every visit, participants completed surveys assessing HPV vaccine-related risk perceptions (perceived risk of sexually transmitted infections [STIs] other than HPV, perceived need for safer sexual behaviors), and sexual initiation. Outcomes were sexual initiation and age of sexual initiation. Associations between risk perceptions and outcomes were examined using ordered logistic regression models for sexual initiation and interval censored survival analyses for age of sexual initiation. RESULTS: Mean age at baseline was 14.9 years (standard deviation [SD] 1.4). Most participants perceived themselves to be at risk of STIs other than HPV (mean scale score = 4.0/10; SD 2.1) and perceived a need for safer sexual behaviors (mean scale score = 1.5/10; SD 1.5). By 30 months, 65 participants (78%) initiated sex. Perceived risk of STIs and perceived need for safer sexual behaviors were not associated with sexual initiation or age of sexual initiation. Older age at baseline was associated with sooner sexual initiation (p = .02) and older age at sexual initiation (p < .001). Results of ordered logistic regression and survival analyses were unchanged when controlling for baseline age. CONCLUSIONS: HPV vaccine-related risk perceptions were not associated with sexual initiation or age of sexual initiation, providing further support that HPV vaccine-related risk perceptions are unlikely to lead to riskier sexual behaviors.
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    An OLS-Based Method for Causal Inference in Observational Studies
    (2019-07) Xu, Yuanfang; Zhang, Ying; Huang, Bin; Tu, Wanzhu; Bakoyannis, Giorgos; Song, Yiqing
    Observational data are frequently used for causal inference of treatment effects on prespecified outcomes. Several widely used causal inference methods have adopted the method of inverse propensity score weighting (IPW) to alleviate the in uence of confounding. However, the IPW-type methods, including the doubly robust methods, are prone to large variation in the estimation of causal e ects due to possible extreme weights. In this research, we developed an ordinary least-squares (OLS)-based causal inference method, which does not involve the inverse weighting of the individual propensity scores. We first considered the scenario of homogeneous treatment effect. We proposed a two-stage estimation procedure, which leads to a model-free estimator of average treatment effect (ATE). At the first stage, two summary scores, the propensity and mean scores, are estimated nonparametrically using regression splines. The targeted ATE is obtained as a plug-in estimator that has a closed form expression. Our simulation studies showed that this model-free estimator of ATE is consistent, asymptotically normal and has superior operational characteristics in comparison to the widely used IPW-type methods. We then extended our method to the scenario of heterogeneous treatment effects, by adding in an additional stage of modeling the covariate-specific treatment effect function nonparametrically while maintaining the model-free feature, and the simplicity of OLS-based estimation. The estimated covariate-specific function serves as an intermediate step in the estimation of ATE and thus can be utilized to study the treatment effect heterogeneity. We discussed ways of using advanced machine learning techniques in the proposed method to accommodate high dimensional covariates. We applied the proposed method to a case study evaluating the effect of early combination of biologic & non-biologic disease-modifying antirheumatic drugs (DMARDs) compared to step-up treatment plan in children with newly onset of juvenile idiopathic arthritis disease (JIA). The proposed method gives strong evidence of significant effect of early combination at 0:05 level. On average early aggressive use of biologic DMARDs leads to around 1:2 to 1:7 more reduction in clinical juvenile disease activity score at 6-month than the step-up plan for treating JIA.
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    Substantial Decline in Vaccine-Type Human Papillomavirus (HPV) Among Vaccinated Young Women During the First 8 Years After HPV Vaccine Introduction in a Community
    (Oxford University Press, 2016-11-15) Kahn, Jessica A.; Widdice, Lea E.; Ding, Lili; Huang, Bin; Brown, Darron R.; Franco, Eduardo L.; Bernstein, David I.; Medicine, School of Medicine
    During the first 8 years after human papillomavirus (HPV) vaccine introduction in a community, vaccine-type HPV prevalence decreased >90% in vaccinated young women, demonstrating high vaccine effectiveness, and decreased >30% in unvaccinated young women, providing evidence of herd protection., Background. Human papillomavirus (HPV) vaccine effectiveness and herd protection are not well established in community settings. Our objective was to determine trends in vaccine-type HPV in young women during the 8 years after vaccine introduction, to assess changes in HPV prevalence and characterize herd protection in a community., Methods. We recruited 3 samples of sexually experienced, 13–26-year-old adolescent girls and young women (hereafter women; N = 1180) from 2006–2014: before widespread vaccine introduction (wave 1) and 3 (wave 2) and 7 (wave 3) years after vaccine introduction. We determined the prevalence of vaccine-type HPV (HPV-6, -11, -16, and -18) among all, vaccinated, and unvaccinated women at waves 1, 2, and 3, adjusted for differences in participant characteristics, then examined whether changes in HPV prevalence were significant using inverse propensity score–weighted logistic regression., Results. Vaccination rates increased from 0% to 71.3% across the 3 waves. Adjusted vaccine-type HPV prevalence changed from 34.8% to 8.7% (75.0% decline) in all women, from 34.9% to 3.2% (90.8% decline) in vaccinated women, and from 32.5% to 22.0% (32.3% decline) in unvaccinated women. Among vaccinated participants, vaccine-type HPV prevalence decreased significantly from wave 1 to wave 2 (adjusted odds ratio, 0.21; 95% confidence interval, .13–.34) and from wave 1 to wave 3 (0.06; .03–.13). The same decreases were also significant among unvaccinated participants (adjusted odds ratios, 0.44; [95% confidence interval, .27–.71] and 0.59; [.35–.98], respectively)., Conclusions. The prevalence of vaccine-type HPV decreased >90% in vaccinated women, demonstrating high effectiveness in a community setting, and >30% in unvaccinated women, providing evidence of herd protection.