Clinical Focus

  • Pediatric Rheumatology

Academic Appointments

Honors & Awards

  • ACR/ REF/ LRI Lupus Investigator Fellowship Award, American College of Rheumatology (2004-2007)

Boards, Advisory Committees, Professional Organizations

  • Member, American College of Rheumatology (2003 - Present)
  • Member, Childhood Arthritis and Rheumtology Research Alliance (CARRA) (2004 - Present)
  • Member, Pediatric Rheumatology Care and Outcomes Improvement Network (PR COIN) (2011 - Present)

Professional Education

  • Board Certification: Pediatrics, American Board of Pediatrics (2002)
  • Residency:UCLA Medical Center (2002) CA
  • Internship:UCLA Medical Center (2000) CA
  • Fellowship:Stanford University Pediatric Rheumatology (2006) CA
  • Medical Education:Washington University School Of Medicine (1999) MO
  • Board Certification: Pediatric Rheumatology, American Board of Pediatrics (2006)
  • BA, UC Berkeley, Molecular & Cell Biology (1995)
  • MD, Washington University, Medicine (1999)
  • MS, Stanford University, Health Research and Policy (2007)

Community and International Work

  • Arthritis Foundation


    juvenile arthritis


    Bay Area

    Ongoing Project


    Opportunities for Student Involvement


Research & Scholarship

Current Research and Scholarly Interests

Pediatric Systemic Lupus Erythematosus;

Lupus Nephritis;

Racial/Ethnic Differences in Pediatric Lupus Patients

CARRA Registry

Clinical Trials

  • Observational Study of Pediatric Rheumatic Diseases: The CARRA Registry Recruiting

    Continuation of the CARRA Registry as described in the protocol will support data collection on patients with pediatric-onset rheumatic diseases. The CARRA Registry will form the basis for future CARRA studies. In particular, this observational registry will be used to answer pressing questions about therapeutics used to treat pediatric rheumatic diseases, including safety questions.

    View full details


2017-18 Courses


All Publications

  • The Juvenile Psoriatic Arthritis Cohort in the CARRA Registry: Clinical Characteristics, Classification, and Outcomes JOURNAL OF RHEUMATOLOGY Zisman, D., Gladman, D. D., Stoll, M. L., Strand, V., Lavi, I., Hsu, J. J., Mellins, E. D. 2017; 44 (3): 342-351


    Children with clinically diagnosed juvenile psoriatic arthritis (JPsA) who were enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry (CARRA-JPsA) were classified according to pediatric International League of Associations for Rheumatology (ILAR) and adult criteria [Classification criteria for Psoriatic Arthritis (CASPAR)]. Data on demographic and clinical features at baseline and 1-year followup were analyzed and compared.Cross-sectional analysis was performed of CARRA-JPsA patients enrolled between May 2010 and December 2013 and stratified according to age at disease onset (≤ or > 4 yrs). Features of patients fulfilling ILAR and CASPAR criteria were compared at baseline and followup using chi square, Fisher's exact, Mann-Whitney-McNemar, Wilcoxon signed rank, and t tests, as appropriate.Among 361 children enrolled as CARRA-JPsA, 72.02% had symptom onset at > 4 years of age, with a male predominance and high prevalence of enthesitis. At followup, statistically significant improvements were reported in arthritis, dactylitis, enthesitis, psoriasis, sacroiliitis, and nail pitting, but not in health questionnaire (HQ) scores. Of the patients, 80.5% fulfilled ILAR criteria for JPsA. Fifty-two patients, whose disease fulfilled CASPAR criteria but had not been included in the JPsA cohort, manifested more enthesitis, sacroiliitis, inflammatory bowel disease and uveitis and less psoriasis.The data support division of patients with JPsA into 2 clinical subgroups, according to age at disease onset. Improvement in objective findings did not correlate with changes in HQ scores. Pediatric rheumatologists currently do not diagnose JPsA in all children whose disease manifestations meet CASPAR criteria. Unification of adult and pediatric PsA classification criteria warrants consideration.

    View details for DOI 10.3899/jrheum.160717

    View details for Web of Science ID 000396031600013

    View details for PubMedID 28148698

  • Novel Method to Collect Medication Adverse Events in Juvenile Arthritis: Results From the Childhood Arthritis and Rheumatology Research Alliance Enhanced Drug Safety Surveillance Project ARTHRITIS CARE & RESEARCH Ringold, S., Hendrickson, A., Abramson, L., Beukelman, T., Blier, P. R., Bohnsack, J., Chalom, E. C., Gewanter, H. L., Gottlieb, B., Hollister, R., Hsu, J., Hudgins, A., Ilowite, N. T., Klein-Gitelman, M., Lindsley, C., Lopez Benitez, J. M., Lovell, D. J., Mason, T., Milojevic, D., Moorthy, L. N., Nanda, K., Onel, K., Prahalad, S., Rabinovich, C. E., Ray, L., Rouster-Stevens, K., Ruth, N., Shishov, M., Spalding, S., Syed, R., Stoll, M., Vehe, R. K., Weiss, J. E., White, A. J., Wallace, C. A., Sobel, R. E. 2015; 67 (4): 529-537


    Few data are available regarding the rates of serious adverse events (SAEs) and important medical events (IMEs) outside of product-based registries and clinical trials for juvenile idiopathic arthritis (JIA). The Enhanced Drug Safety Surveillance Project (EDSSP) was developed to pilot a novel system to collect SAEs/IMEs in children with JIA. This analysis reports the results from this 4-year (2008-2012) EDSSP.Participating physicians were surveyed monthly to ascertain whether their JIA patients experienced an SAE or IME. Sites were surveyed every 6 months to determine the number of unique JIA patients seen at each site during that 6-month period. Reporting rates were calculated per 100 person-years and 95% confidence intervals (95% CIs) were calculated based on a Poisson distribution.Thirty-seven Childhood Arthritis and Rheumatology Research Alliance sites with 115 physicians participated. The mean response rate to the monthly surveys was 65%. There were 147 total SAEs and 145 total IMEs. The largest proportion of SAEs and IMEs occurred in children with polyarticular JIA (39% and 37%, respectively). The majority of SAEs and IMEs were reported for patients receiving therapy with biologic agents (76% and 69%, respectively). The total event rate for SAEs and IMEs combined was 1.07 events per 100 person-years (95% CI 0.95-1.19). The rates for SAEs and IMEs were 0.54 per 100 person-years (95% CI 0.45-0.63) and 0.53 per 100 person-years (95% CI 0.49-0.62), respectively.The EDSSP provided a simple tool for SAE/IME reporting within an established research network and resulted in a similar range of reported events as captured by a traditional product-based registry.

    View details for DOI 10.1002/acr.22487

    View details for Web of Science ID 000352111800010

    View details for PubMedID 25331530

  • European ancestry decreases the risk of early onset, severe lupus nephritis in a single center, multiethnic pediatric lupus inception cohort LUPUS Frankovich, J. D., Hsu, J. J., Sandborg, C. I. 2012; 21 (4): 421-429


    To determine whether pediatric SLE patients without European ancestry are at higher risk for development of severe lupus nephritis (ISN/RPS class III, IV or V).Ninety-eight of 101 patients with pediatric SLE (age <18 years at diagnosis) were enrolled. Race/ethnicity of four grandparents, socioeconomic status (SES) and language proficiency were collected. The primary outcome was time to development of severe lupus nephritis.Based on patient report of four grandparent ancestry, 29% had at least one grandparent of European ancestry (14% had all four grandparents of European ancestry). Patients without European ancestry were 46% Hispanic, 47% Asian, and 3% African American. In the entire 98 patient cohort, 12% had ≥3 different ancestries. Patients without European ancestry had significantly lower SES levels and English proficiency. There was no significant difference between patients with or without European ancestry in duration of SLE, age of onset, and lag time between symptoms and diagnosis. Patients with at least one grandparent of European ancestry had a decreased risk of developing severe lupus nephritis, which remained significant after controlling for age, gender, SES and English proficiency (hazard ratio 0.4, 95% confidence interval 0.2-0.9).This study demonstrates that presence of at least one grandparent of European ancestry decreases the risk of severe lupus nephritis, a finding that is not explained by measurable socioeconomic differences and language barriers.

    View details for DOI 10.1177/0961203312437805

    View details for Web of Science ID 000301583400008

    View details for PubMedID 22427363