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Dive into the research topics where Norman T. Ilowite is active.

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Featured researches published by Norman T. Ilowite.


Arthritis & Rheumatism | 2011

Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: Report of forty-six patients from an international multicenter series

Peter Nigrovic; Melissa L. Mannion; Femke H. M. Prince; Andrew Zeft; C. Egla Rabinovich; Marion A. J. van Rossum; Elisabetta Cortis; Manuela Pardeo; Paivi Miettunen; Ginger Janow; James D. Birmingham; Aaron T Eggebeen; Erin Janssen; Andrew I. Shulman; Mary Beth Son; Sandy D. Hong; Karla N. Jones; Norman T. Ilowite; Randy Q. Cron; Gloria C. Higgins

OBJECTIVE To examine the safety and efficacy of the interleukin-1 (IL-1) receptor antagonist anakinra as first-line therapy for systemic juvenile idiopathic arthritis (JIA). METHODS Patients with systemic JIA receiving anakinra as part of initial disease-modifying antirheumatic drug (DMARD) therapy were identified from 11 centers in 4 countries. Medical records were abstracted using a standardized instrument, and resulting data were analyzed to characterize concomitant therapies, clinical course, adverse events, and predictors of outcome. RESULTS Among 46 patients meeting inclusion criteria, anakinra monotherapy was used in 10 patients (22%), while 67% received corticosteroids and 33% received additional DMARDs. Outcomes were evaluated at a median followup interval of 14.5 months. Fever and rash resolved within 1 month in >95% of patients, while C-reactive protein and ferritin normalized within this interval in >80% of patients. Active arthritis persisted at 1 month in 39% of patients, at 3 months in 27%, and at >6 months of followup in 11%. Approximately 60% of patients, including 8 of 10 receiving anakinra monotherapy, attained a complete response without escalation of therapy. Disease characteristics and treatment were similar in partial and complete responders, except that partial responders were markedly younger at onset (median age 5.2 years versus 10.2 years; P = 0.004). Associated adverse events included documented bacterial infection in 2 patients and hepatitis in 1 patient. Tachyphylaxis was not observed. CONCLUSION Anakinra as first-line therapy for systemic JIA was associated with rapid resolution of systemic symptoms and prevention of refractory arthritis in almost 90% of patients during the interval examined. These results justify further study of IL-1 inhibition as first-line, rather than rescue, therapy in systemic JIA.


Arthritis Care and Research | 2012

Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis.

Esi Morgan DeWitt; Yukiko Kimura; Timothy Beukelman; Peter Nigrovic; Karen Onel; Sampath Prahalad; Rayfel Schneider; Matthew L. Stoll; Sheila T. Angeles-Han; Diana Milojevic; Kenneth N. Schikler; Richard K. Vehe; Jennifer E. Weiss; Pamela F. Weiss; Norman T. Ilowite; Carol A. Wallace

There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (JIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of systemic JIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies.


Arthritis & Rheumatism | 2009

Premature atherosclerosis in pediatric systemic lupus erythematosus: Risk factors for increased carotid intima‐media thickness in the atherosclerosis prevention in pediatric lupus erythematosus cohort

Laura E. Schanberg; Christy Sandborg; Huiman X. Barnhart; Stacy P. Ardoin; Eric Yow; Gregory W. Evans; Kelly L. Mieszkalski; Norman T. Ilowite; Anne Eberhard; Deborah M. Levy; Yukiko Kimura; Emily von Scheven; Earl D. Silverman; Suzanne L. Bowyer; Lynn Punaro; Nora G. Singer; David D. Sherry; Deborah McCurdy; Marissa Klein-Gitelman; Carol A. Wallace; Richard M. Silver; Linda Wagner-Weiner; Gloria C. Higgins; Hermine I. Brunner; Lawrence Jung; Jennifer B. Soep; Ann M. Reed

OBJECTIVE To evaluate risk factors for subclinical atherosclerosis in a population of patients with pediatric systemic lupus erythematosus (SLE). METHODS In a prospective multicenter study, a cohort of 221 patients underwent baseline measurements of carotid intima-media thickness (CIMT) as part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial. SLE disease measures, medications, and traditional risk factors for atherosclerosis were assessed. A standardized protocol was used to assess the thickness of the bilateral common carotid arteries and the mean maximal IMT of 12 segments. Univariable analysis identified potential associations with CIMT, which were examined in multivariable linear regression modeling. RESULTS Based on the mean-mean common or the mean-max CIMT as the dependent variable, univariable analysis showed significant associations of the following variables with increased CIMT: increasing age, longer SLE duration, minority status, higher body mass index (BMI), male sex, increased creatinine clearance, higher lipoprotein(a) level, proteinuria, azathioprine treatment, and prednisone dose. In multivariable modeling, both azathioprine use (P=0.005 for the mean-mean model and P=0.102 for the mean-max model) and male sex (P<0.001) were associated with increases in the mean-max CIMT. A moderate dosage of prednisone (0.15-0.4 mg/kg/day) was associated with decreases in the mean-max CIMT (P=0.024), while high-dose and low-dose prednisone were associated with increases in the mean-mean common CIMT (P=0.021) and the mean-max CIMT (P=0.064), respectively. BMI (P<0.001) and creatinine clearance (P=0.031) remained associated with increased mean-mean common CIMT, while increasing age (P<0.001) and increasing lipoprotein(a) level (P=0.005) were associated with increased mean-max CIMT. CONCLUSION Traditional as well as nontraditional risk factors were associated with increased CIMT in this cohort of patients in the APPLE trial. Azathioprine treatment was associated with increased CIMT. The relationship between CIMT and prednisone dose may not be linear.


Arthritis Care and Research | 2012

Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus

Rina Mina; Emily von Scheven; Stacy P. Ardoin; B. Anne Eberhard; Marilynn Punaro; Norman T. Ilowite; Joyce Hsu; Marisa S. Klein-Gitelman; L. Nandini Moorthy; Eyal Muscal; Suhas M. Radhakrishna; Linda Wagner-Weiner; Matthew Adams; Peter R. Blier; Lenore M. Buckley; Elizabeth C. Chalom; Gaëlle Chédeville; Andrew H. Eichenfield; Natalya Fish; Michael Henrickson; Aimee O. Hersh; Roger Hollister; Olcay Jones; Lawrence Jung; Deborah M. Levy; Jorge M. Lopez-Benitez; Deborah McCurdy; Paivi Miettunen; Ana I. Quintero-Del Rio; Deborah Rothman

To formulate consensus treatment plans (CTPs) for induction therapy of newly diagnosed proliferative lupus nephritis (LN) in juvenile systemic lupus erythematosus (SLE).


Arthritis & Rheumatism | 2012

Use of Atorvastatin in Systemic Lupus Erythematosus in Children and Adolescents

Laura E. Schanberg; Christy Sandborg; Huiman X. Barnhart; Stacy P. Ardoin; Eric Yow; Gregory W. Evans; Kelly L. Mieszkalski; Norman T. Ilowite; Anne Eberhard; Lisa Imundo; Yukiko Kimura; E. Von Scheven; Edwin K. Silverman; Suzanne L. Bowyer; Marilynn Punaro; Nora G. Singer; David D. Sherry; Deborah McCurdy; Marissa Klein-Gitelman; Carol A. Wallace; Richard M. Silver; Linda Wagner-Weiner; Gloria C. Higgins; Hermine I. Brunner; Lawrence Jung; Jennifer B. Soep; Ann M. Reed; James M. Provenzale; Susan D. Thompson

OBJECTIVE Statins reduce atherosclerosis and cardiovascular morbidity in the general population, but their efficacy and safety in children and adolescents with systemic lupus erythematosus (SLE) are unknown. This study was undertaken to determine the 3-year efficacy and safety of atorvastatin in preventing subclinical atherosclerosis progression in pediatric-onset SLE. METHODS A total of 221 participants with pediatric SLE (ages 10-21 years) from 21 North American sites were enrolled in the Atherosclerosis Prevention in Pediatric Lupus Erythematosus study, a randomized double-blind, placebo-controlled clinical trial, between August 2003 and November 2006 with 36-month followup. Participants were randomized to receive atorvastatin (n=113) or placebo (n=108) at 10 or 20 mg/day depending on weight, in addition to usual care. The primary end point was progression of mean-mean common carotid intima-media thickening (CIMT) measured by ultrasound. Secondary end points included other segment/wall-specific CIMT measures, lipid profile, high-sensitivity C-reactive protein (hsCRP) level, and SLE disease activity and damage outcomes. RESULTS Progression of mean-mean common CIMT did not differ significantly between treatment groups (0.0010 mm/year for atorvastatin versus 0.0024 mm/year for placebo; P=0.24). The atorvastatin group achieved lower hsCRP (P=0.04), total cholesterol (P<0.001), and low-density lipoprotein (P<0.001) levels compared with placebo. In the placebo group, CIMT progressed significantly across all CIMT outcomes (0.0023-0.0144 mm/year; P<0.05). Serious adverse events and critical safety measures did not differ between groups. CONCLUSION Our results indicate that routine statin use over 3 years has no significant effect on subclinical atherosclerosis progression in young SLE patients; however, further analyses may suggest subgroups that would benefit from targeted statin therapy. Atorvastatin was well tolerated without safety concerns.


Arthritis Care and Research | 2012

Development of consensus treatment plans for juvenile localized scleroderma: A roadmap toward comparative effectiveness studies in juvenile localized scleroderma

Suzanne C. Li; Kathryn S. Torok; Elena Pope; Fatma Dedeoglu; Sandy D. Hong; Heidi Jacobe; C. Egla Rabinovich; Ronald M. Laxer; Gloria C. Higgins; Polly J. Ferguson; Andrew Lasky; Kevin W. Baszis; Mara L. Becker; Sarah Campillo; Victoria Cartwright; Michael Cidon; Christi J Inman; Rita Jerath; Kathleen M. O'Neil; Sheetal S. Vora; Andrew Zeft; Carol A. Wallace; Norman T. Ilowite; Robert C. Fuhlbrigge

Juvenile localized scleroderma (LS) is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies has been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment has made it difficult to compare approaches and identify optimal therapy. Our objective was to develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile LS.


Arthritis Care and Research | 2012

Consensus treatments for moderate juvenile dermatomyositis: Beyond the first two months. Results of the Second Childhood Arthritis and Rheumatology Research Alliance Consensus Conference

Adam M. Huber; Angela Byun Robinson; Ann M. Reed; Leslie Abramson; Sharon Bout-Tabaku; Ruy Carrasco; Megan L. Curran; Brian M. Feldman; Harry L. Gewanter; Thomas A. Griffin; Kathleen A. Haines; Mark F. Hoeltzel; Josephine Isgro; Philip Kahn; Bianca Lang; Patti Lawler; Bracha Shaham; Heinrike Schmeling; Rosie Scuccimarri; Michael Shishov; Elizabeth Stringer; Julie Wohrley; Norman T. Ilowite; Carol A. Wallace

To use consensus methods and the considerable expertise contained within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) organization to extend the 3 previously developed treatment plans for moderate juvenile dermatomyositis (DM) to span the full course of treatment.


Arthritis & Rheumatism | 2014

Randomized, Double-Blind, Placebo-Controlled Trial of the Efficacy and Safety of Rilonacept in the Treatment of Systemic Juvenile Idiopathic Arthritis

Norman T. Ilowite; Kristi Prather; Yuliya Lokhnygina; Laura E. Schanberg; Melissa E. Elder; Diana Milojevic; James W. Verbsky; Steven J. Spalding; Yukiko Kimura; Lisa Imundo; Marilynn Punaro; David D. Sherry; Stacey E. Tarvin; Lawrence S. Zemel; James D. Birmingham; Beth S. Gottlieb; Michael L. Miller; Kathleen M. O'Neil; Natasha M. Ruth; Carol A. Wallace; Nora G. Singer; Christy Sandborg

To assess the efficacy and safety of rilonacept, an interleukin‐1 inhibitor, in a randomized, double‐blind, placebo‐controlled trial.


Arthritis Care and Research | 2013

2013 Update of the 2011 American college of rheumatology recommendations for the treatment of juvenile idiopathic arthritis

Sarah Ringold; Pamela F. Weiss; Timothy Beukelman; Esi Morgan DeWitt; Norman T. Ilowite; Yukiko Kimura; Ronald M. Laxer; Daniel J. Lovell; Peter Nigrovic; Angela Byun Robinson; Richard K. Vehe

Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.


Arthritis Care and Research | 2011

Measuring process of arthritis care: A proposed set of quality measures for the process of care in juvenile idiopathic arthritis

Daniel J. Lovell; Murray H. Passo; Timothy Beukelman; Suzanne L. Bowyer; Beth S. Gottlieb; Michael Henrickson; Norman T. Ilowite; Yukiko Kimura; Esi Morgan DeWitt; Jill Segerman; Janalee Taylor; Richard K. Vehe; Edward H. Giannini

The ability to assess quality of care is a necessary component of continuous quality improvement. The assessment typically is accomplished by determination of compliance with a defined set of quality measures (QMs). The objective of this effort was to establish a set of QMs for the assessment of the process of care in juvenile idiopathic arthritis (JIA).

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Yukiko Kimura

Hackensack University Medical Center

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Gloria C. Higgins

Nationwide Children's Hospital

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Daniel J. Lovell

Cincinnati Children's Hospital Medical Center

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Hermine I. Brunner

Cincinnati Children's Hospital Medical Center

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Beth S. Gottlieb

Boston Children's Hospital

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