Daniel B. Horton's research while affiliated with Robert Wood Johnson Foundation and other places

Publications (59)

Article
Objective: Children with well-controlled juvenile idiopathic arthritis (JIA) frequently flare after medication discontinuation, but the outcomes of these flares have not been well described. The objective of this study was to characterize the rates and predictors of disease recapture among children with JIA who restarted medication to treat diseas...
Article
Full-text available
Importance: Cytokine signaling, including tumor necrosis factor (TNF) and interleukin (IL)-6, through the Janus-kinase (JAK)-signal transducer and activator of transcription pathway, was hypothesized to attenuate the risk of Alzheimer disease and related dementia (ADRD) in the Drug Repurposing for Effective Alzheimer Medicines (DREAM) initiative b...
Article
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Objective: To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are...
Article
Objective: To provide recommendations for the management of juvenile idiopathic arthritis (JIA) with a focus on nonpharmacologic therapies, medication monitoring, immunizations, and imaging, irrespective of JIA phenotype. Methods: We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conduct...
Article
Full-text available
Objective: To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are...
Article
Objective: To provide recommendations for the management of juvenile idiopathic arthritis (JIA) with a focus on nonpharmacologic therapies, medication monitoring, immunizations, and imaging, irrespective of JIA phenotype. Methods: We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conduct...
Chapter
This chapter presents selected special applications of pharamcoepidemiology, which include studies of drug utilization; evaluating and improving prescribing; special methodological issues in pharmacoepidemiologic studies of vaccine safety; epidemiologic studies of implantable medical devices; research on the effects of medications in pregnancy and...
Chapter
Electronic health record (EHR) databases are longitudinal patient record databases that are used by clinicians in caring for their patients and anonymized for the purpose of research. This chapter focuses on selected European primary care EHR databases and a national EHR database for United States Veterans. European EHR databases may contain region...
Article
Full-text available
Monitoring the burden and spread of infection with the new coronavirus SARS-CoV-2, whether within small communities or in large geographical settings, is of paramount importance for public health purposes. Serology, which detects the host antibody response to the infection, is the most appropriate tool for this task, since virus-derived markers are...
Article
Many autoimmune diseases confer a higher risk of cancer on patients compared to the general population. A controversial factor tying autoimmune diseases to malignancy is harm from immunosuppressive treatment. Nonetheless, multiple sclerosis is different from other autoimmune diseases, and findings from other disease populations may not apply. In th...
Article
Background We studied risk factors, antibody responses, and symptoms of SARS-CoV-2 infection in a diverse, ambulatory population. Methods A prospective cohort (n=831, including 548 hospital-based healthcare workers) previously undiagnosed with SARS-CoV-2 infection was followed for six months with serial testing (SARS-CoV-2 PCR, specific IgG) and s...
Preprint
Full-text available
Monitoring the burden and spread of infection with the new coronavirus SARS-CoV-2, whether within small communities or in large geographical settings, is of paramount importance for public health purposes. Serology, which detects the host antibody response to the infection, is the most appropriate tool for this task, since virus-derived markers are...
Article
Full-text available
Background Although prior literature suggests that metoprolol may worsen glucose control compared to carvedilol, whether this has clinical relevance among older adults with diabetes and heart failure remains an open question. Methods This was a US retrospective cohort study utilizing data sourced from a 50% national sample of Medicare fee-for-serv...
Preprint
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Given the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the recent implementation of SARS-CoV-2 vaccination, we have much to learn about the duration of immune protection and the interface between the immune responses to infection and to vaccination. To address these questions, we monitored immune respon...
Article
Background : Adults with mood and anxiety disorders have an increased likelihood of being prescribed opioids. The influence of other mental disorders, such as psychotic and attention disorders, on opioid prescribing patterns is less known. Methods : We studied a population-representative sample of 166,927 outpatient visits for adults with painful...
Article
We report a case of COVID-19 in a pediatric patient with systemic lupus erythematosus (SLE), who presented with respiratory distress marked by increased work of breathing and low oxygen saturation. Lab tests confirmed COVID-19, and showed lymphocytopenia and elevated markers of inflammation and coagulopathy. Chest X-ray showed bilateral mid-lung op...
Article
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Background Heatwaves kill more people than floods, tornadoes, and earthquakes combined and disproportionally affect older persons and those with chronic conditions. Commonly used medications for chronic conditions, e.g., diuretics, antipsychotics disrupt thermoregulation or fluid/electrolyte balance and may sensitive patients to heat. However, the...
Article
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Drug discovery for disease-modifying therapies for Alzheimer's disease and related dementias (ADRD) based on the traditional paradigm of experimental animal models has been disappointing. We describe the rationale and design of the Drug Repurposing for Effective Alzheimer's Medicines (DREAM) study, an innovative multidisciplinary alternative to tra...
Article
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Background Healthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. However, there has been little epidemiological research to assess these risks. Methods We conducted a prospective cohort study of HCW (n = 546) and non...
Article
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Background SARS-CoV-2 infection is a critical concern among health care workers (HCW). Other studies have assessed SARS-CoV-2 virus and antibodies in HCW, with disparate findings regarding risk based on role and demographics. Methods We screened 3,904 employees and clinicians for SARS-CoV-2 virus positivity and serum IgG at a major New Jersey hosp...
Article
Objective: Biologic medications have significantly improved disease control and outcomes of patients with juvenile idiopathic arthritis (JIA). Current treatment recommendations suggest escalating therapy; including changing biologics if needed, when inactive or low disease activity is not attained. The patterns and reasons for switching biologics...
Article
This study quantified rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children ages 1-18. The retrospective cohort included >930,000 children diagnosed with autoimmune diseases (inflammatory bowel disease, juvenile idiopathic arthritis, or psoriasis) o...
Article
Objective Fibromyalgia is defined by idiopathic, chronic, widespread musculoskeletal pain. In adults with fibromyalgia, meta-analysis of lower-leg skin biopsy demonstrated 45% pooled prevalence of abnormally low epidermal neurite density (END). END <5th centile of the normal distribution is the consensus diagnostic threshold for small-fiber neuropa...
Article
As the COVID-19 pandemic sweeps across the world, the availability of viral transport media (VTM) has become severely limited, contributing to delays in diagnosis and rationing of diagnostic testing. Given that SARS-CoV-2 viral RNA has demonstrated stability, we posited that phosphate buffered saline (PBS) may be a viable transport medium, as an al...
Preprint
Full-text available
Importance: Healthcare workers are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. However, no epidemiological study has examined the prevalence of SARS-CoV-2 infection in a cohort of healthcare workers during the early phase of community t...
Article
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Background The promise of real-world evidence (RWE) is especially relevant to pediatrics, where medicines prescribed for children are often used without evidence derived from randomized clinical trials.Objectives The aim of this systematic review was to describe the state of RWE in pediatrics by identifying observational studies published during 20...
Article
Objective: Improved treatments for juvenile idiopathic arthritis (JIA) have increased remission rates. We investigated how patients and caregivers make decisions about stopping medications for well-controlled JIA. Methods: We performed a mixed-methods study of caregivers and patients affected by JIA, recruited through social media and flyers and...
Chapter
Premarketing studies typically exclude pregnant women and children, although new regulations have promoted their inclusion in clinical trials. Thus, usage of medicines off‐label and off‐evidence in these vulnerable populations remains common, and pharmacoepidemiology has an important role in supplying critical missing evidence about the beneficial...
Chapter
Electronic health record databases are longitudinal patient record databases that are used by clinicians in caring for their patients and secondarily used for the purpose of research, often in anonymized format. Information from electronic health record databases is thought more likely than data from administrative databases to reflect patients’ tr...
Article
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Background Early diagnosis and treatment of juvenile idiopathic arthritis (JIA) with conventional and biologic disease-modifying anti-rheumatic drugs have vastly improved outcomes for children with these diseases. Currently, a large proportion of children with JIA are able to achieve clinical inactive disease and remission. With this success, impor...
Article
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Daniel B Horton,1–3 Susan Shenoi4 1Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; 2Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA; 3Department of Biostatistics and Epidemiology, Rutgers School of Public...
Article
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Linkage of medical databases, including insurer claims and electronic health records (EHRs), is increasingly common. However, few studies have investigated the behavior and output of linkage software. To determine how linkage quality is affected by different algorithms, blocking variables, methods for string matching and weight determination, and d...
Article
Background: Off-label drug use in children is common and potentially harmful. In most previous off-label use research, authors studied hospitalized children, specific drug classes, or non-US settings. We characterized frequencies, trends, and reasons for off-label systemic drug orders for children in ambulatory US settings. Methods: Using nation...
Article
Respiratory infections are extremely common pediatric illnesses, and families frequently treat children with cough and cold medicines (CCM). In 2008, the US Food and Drug Administration (FDA) recommended that children younger than 2 years not use over-the-counter (OTC) CCM given concerns about efficacy and safety.¹ Soon thereafter, manufacturers vo...
Conference Paper
Background Systemic glucocorticoid use is associated with a well-known spectrum of toxicities. Nonetheless, the risks of cardiometabolic complications in children are poorly understood. Objectives We sought to quantify rates of newly treated diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid expos...
Article
Objective Few factors have consistently been linked to antibiotic-refractory Lyme arthritis (ARLA). We sought to identify clinical and treatment factors associated with pediatric ARLA. Methods We performed a case-control study in 3 pediatric rheumatology clinics in a Lyme-endemic region (2000–2013). Eligible children were aged ≤ 18 years with arth...
Article
Objective To determine whether second-line intra-articular glucocorticoid (IAGC) injection improves outcomes in children with persistently active Lyme arthritis after initial antibiotics. Methods We conducted an observational comparative effectiveness study through chart review within three pediatric rheumatology centers with distinct clinical app...
Article
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Objective The current Juvenile Idiopathic Arthritis (JIA) Core Set used in randomized controlled trials (RCTs) and longitudinal observational studies (LOS) was developed without input of patients/parents. At OMERACT 2016, a special interest group voted to reconsider the core set incorporating broader stakeholder input. We describe subsequent work c...
Article
When we diagnose children with juvenile idiopathic arthritis, JIA's middle name serves as a reminder of our ignorance of its origins. Even the largest, most comprehensive genomic studies on JIA performed to date have explained only a minority of disease heritability. Families rightfully ask why their children have developed this condition, and many...
Article
Objective To determine whether tumour necrosis factor inhibitor (TNFi) use is associated with an increased rate of incident malignancy compared with no TNFi use in the treatment of juvenile idiopathic arthritis (JIA), paediatric inflammatory bowel disease (pIBD) and paediatric plaque psoriasis (pPsO). Methods We performed a retrospective cohort st...
Article
Purpose: Newly approved novel drugs in Europe receive a black triangle label to promote pharmacovigilance. With growing momentum for earlier drug approvals and reliance on real-world evidence, we studied if the black triangle label promotes more judicious prescribing. Methods: We examined whether general practitioners prescribed escitalopram, ta...
Article
Objective: The current Juvenile Idiopathic Arthritis (JIA) Core Set was developed in 1997 to identify the outcome measures to be used in JIA clinical trials using statistical and consensus-based techniques, but without patient involvement. The importance of patient/parent input into the research process has increasingly been recognized over the ye...
Article
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Objectives We studied oral glucocorticoids and osteonecrosis, a rare but serious bone disease, in individuals with various chronic inflammatory diseases. We hypothesised that we would find stronger associations in adults versus children and in people with autoimmune diseases. Design Retrospective cohort study. Setting Population-representative da...
Article
Full-text available
Background: Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment a...
Article
Objective: To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA). Methods: Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed an anonymous electronic survey on decision making and app...
Article
Unlabelled: Voltage-gated sodium channel Nav1.7 is a central player in human pain. Mutations in Nav1.7 produce several pain syndromes, including inherited erythromelalgia (IEM), a disorder in which gain-of-function mutations render dorsal root ganglia (DRG) neurons hyperexcitable. Although patients with IEM suffer from episodes of intense burning...
Article
Importance The incidence of Clostridium difficile infection has increased among children. The epidemiology of pediatric C difficile infection–associated reactive arthritis is poorly understood. Objective To characterize the incidence, recognition, and distinguishing clinical features of pediatric C difficile infection–associated reactive arthritis...
Article
Background & aims: Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort...
Article
Importance Antibiotics disrupt human microbiota and have been associated with several pediatric autoimmune diseases. Psoriasis activity has been linked to group A streptococcal and viral infections.Objective To determine whether antibiotic exposure and infections are independently associated with incident psoriasis in children.Design, Setting, an...
Article
Full-text available
Recent evidence has linked childhood antibiotic use and microbiome disturbance to autoimmune conditions. This study tested the hypothesis that antibiotic exposure was associated with newly diagnosed juvenile idiopathic arthritis (JIA). We performed a nested case-control study in a population-representative medical records database from the United K...
Article
Background/Purpose:Clostridium difficile infection (CDI) has increased among children and is associated with significant morbidity and mortality. CDI-associated reactive arthritis (CDIAReA) has been described in adults and a few pediatric case reports, but little is known about CDIAReA in pediatric patients.Methods:Children ages 2–20 with CDIAReA i...
Article
Enthesitis is an extra-intestinal manifestation of inflammatory bowel disease (IBD) in adults. However, little has been published about the prevalence or characteristics of enthesitis in pediatric IBD. We conducted a cross-sectional study of children and young adults ages 4-21 years with IBD. Subjects were recruited among those receiving routine ca...

Citations

... Pediatric investigations prior to commencement of biologic DMARDs treatment should include work up to rule out tuberculosis (Quantiferon/T-spot, chest x-ray), serology for varicella zoster virus (VZV), hepatitis B, and hepatitis C (and HIV when appropriate). Immunizations should be updated prior to starting immunosuppression, according to national recommendations including live attenuated vaccines such as MMR and varicella vaccine when patient is seronegative (155,156). Monitoring of compliance with medications and topical treatment is particularly important in children and adolescent patients. Patient with non-infectious uveitis requiring immunosuppression with poor compliance were shown to achieve less steroid free remission (150,157). ...
... We are in agreement with 2021 ACR Guideline for the Treatment of Juvenile Idiopathic Arthritis [51] in almost all lines of treatment in all categories of JIA, but we consider T2T strategy, and ACR 2021 consider temporomandibular joint in separate section and separate algorithm. And we in these recommendations added a separate section for uveitis management in JIA. ...
... Antibody binding was performed by ELISA utilizing SARS-CoV-2 receptor binding domain (RBD) of the Spike protein as solid-phase antigen, as described 56 . HRP-conjugated mouse anti-human IgG1, IgG2, IgG3, and IgG4 (Southern Biotech, Birmingham, AL, USA) secondary antibodies were used at 1:2,000 dilution. ...
... Patients are at risk of having an attack even when receiving the most appropriate treatments and these immunomodulatory agents potentially have serious side effects, including malignancy. Thus, patients with MS are more likely to seek a second opinion or resort to alternative sources of treatment-related information (Horton and Reder, 2021). ...
... COVID-19 patients present with a variety of symptoms, ranging from asymptomatic infections or mild to severe courses of disease, potentially being also life-threatening and lethal , Miller and Yan, 2021. Patients suffering from severe COVID-19 according to the WHO grading scale (Son et al., 2021) have been reported to develop a potent humoral immune response with high antibody titers against SARS-CoV-2 (Horton et al., 2021. In this study, we are the first to report on the association between symptom severity of subjective symptoms in 193 individuals with asymptomatic SARS-CoV-2 infection or mild to moderate COVID-19 according to WHO (Son et al., 2021) and humoral and cellular immune responses to SARS-CoV-2 by assessing both, serum antibody titers as well as SARS-CoV-2-specific T cell responses. ...
... All study subjects were > 20 years of age. To assess antibody responses to SARS-CoV-2 infection we used plasma/serum samples obtained from 83 SARS-CoV-2 PCR-confirmed convalescent subjects (Mishra et al., 2021); 146 patients hospitalized for COVID-19 (PCR confirmed) at Robert Wood Johnson University Hospital in New Brunswick, NJ; blood collected after >2 weeks from completion of full vaccination from 283 subjects vaccinated against SARS-CoV-2 between mid-December 2020 and mid-February 2021 among healthcare workers in Rutgers-affiliated hospitals (Barrett et al., 2020) and Rutgers employees (Mishra et al., 2021); and 148 residents living in the township of Lakewood, NJ in April 2020. Studies were approved by the Research Subjects Institutional Review Board at the University of Rutgers, Newark, New Jersey (Pro2020000655, Pro2020001263, and ClinicalTrials.gov ...
... 13,37,45,46 The clinical presentation described in paediatric SLE population with COVID-19 might be similar to those in adults, characterised by increased work of breathing and low oxygen saturation. 49 Bozzalla Cassione et al. 13 also reported that 11 of 12 SLE patients with COVID-19 are likely to have a mild and selfresolving disease course. However, patients with mutivisceral SLE damage would be at risk of severe COVID-19. ...
... People can have difficulty with thermoregulation and acclimatization to sudden changes in weather (Garrett et al., 2009), irrespective of the time of year. The decline in thermoregulation with increasing age has also been well documented, suggesting that older adults may be more vulnerable to the effects of climate-related changes in temperature than younger adults (Åström et al., 2011;Kenney and Hodgson, 1987;Kenny et al., 2010;Layton et al., 2020;Martiello and Giacchi, 2010;Shibasaki et al., 2013). There is no certain definition of temperature variability. ...
... ED HCP may have additional risk due to unknown patient infection status, overcrowded facilities lacking adequate ventilation, personal protective equipment (PPE) shortages, unexpected critically ill patient arrivals, and performance of life-saving aerosolizing procedures, such as endotracheal intubation [6,7]. Risk of acquiring infection after intubating a SARS-CoV-2-infected patient has been estimated as high as 3% [8,9]. Even after availability of SARS-CoV-2 vaccination, the Omicron variant has led to widespread infection, primarily from immune evasion, and SARS-CoV-2 infections in vaccinated HCP have been reported [10,11]. ...
... Various studies have confirmed that healthcare workers are at increased risk of SARS-CoV-2 infection [11,12]. Thus, they could also have the highest risk of reinfection during the following surges of the disease, due to continuing work on the frontline against COVID-19. ...