Bio

Bio


Dr. Lin specializes in the diagnosis and treatment of rheumatologic conditions such as rheumatoid arthritis, lupus, myositis, gout, and seronegative spondyloarthropathies. She received additional training in autoimmune skin diseases and has a special clinical and research interest for psoriasis/psoriatic arthritis, dermatomyositis, cutaneous lupus/systemic lupus. She leads a combined rheumatology-dermatology clinic with Dr. Matthew Lewis in the dermatology department to take care patients collaboratively. Dr. Lin is a graduate of USSONAR (Ultrasound School of North American Rheumatologists) program and performs diagnostic musculoskeletal ultrasound evaluation and interventions. In addition to her clinical work, she leads the quality improvement effort for the division and her most recent projects are focused on patient-reported outcome in rheumatoid arthritis and vaccinations for patients in the rheumatology clinic.

Clinical Focus


  • Rheumatology
  • Rheumatology-Dermatology

Academic Appointments


Professional Education


  • Board Certification: Rheumatology, American Board of Internal Medicine (2013)
  • Residency: Icahn School of Medicine at Mount Sinai Hospital Internal Medicine Residency (2011) NY
  • Medical Education: Tufts University School of Medicine Office of the Registrar (2008) MA
  • Subspecialty Fellowship, Brigham and Women's Hospital, Harvard Medical School. Dermatology-Rheumatology Fellowship, MA (2014)
  • Fellowship: New York University Division of Rheumatology (2013) NY
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2011)

Publications

All Publications


  • A Standardized, Pragmatic Approach to Knee Ultrasound for Clinical Research in Osteoarthritis: The Johnston County Osteoarthritis Project. ACR open rheumatology Yerich, N. V., Alvarez, C., Schwartz, T. A., Savage-Guin, S., Renner, J. B., Bakewell, C. J., Kohler, M. J., Lin, J., Samuels, J., Nelson, A. E. 2020

    Abstract

    OBJECTIVE: This study sought to develop and employ a comprehensive and standardized ultrasound (US) protocol and scoring atlas for the evaluation of features relevant to knee osteoarthritis (KOA) in a community-based cohort in the United States, with the goals of demonstrating feasibility, reliability, and validity.METHODS: We utilized data from the fourth follow-up (2016-2018) of the Johnston County OA Project, which includes individuals with (~50%) and without radiographic KOA. All participants underwent standardized knee radiography and completed standard questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS). Bilateral knee US images were obtained by a trained sonographer using a standardized protocol and scored by trained rheumatologists using an atlas developed for this study. A total of 396 knees were each scored by two readers according to the atlas. Associations between US features, radiographic findings (graded by an expert radiologist), and KOOS scores were assessed.RESULTS: Overall interreader reliability for US scoring was fair to moderate. The strongest correlations between US and radiographic features were seen for osteophytes, and similarly strong correlations were seen between US osteophytes and overall radiographic Kellgren-Lawrence Grade, demonstrating criterion validity. Features of effusion/synovitis and osteophytes were most associated with KOOS pain and impaired function.CONCLUSION: US is a feasible, reliable, and valid method to assess features relevant to KOA in clinical and research settings. The protocol and atlas developed in this study can be utilized to evaluate KOA in a standardized fashion in future clinical studies, enabling greater utilization of this valuable modality in osteoarthritis.

    View details for DOI 10.1002/acr2.11159

    View details for PubMedID 32597564

  • Frequency of Ultrasound Features of Knee Osteoarthritis and Their Association with Radiographic Features and Symptoms in a Community-Based Cohort Yerich, N., Alvarez, C., Schwartz, T., Savage-Guin, S., Bakewell, C., Kohler, M., Lin, J., Samuels, J., Nelson, A. WILEY. 2019
  • Systemic Treatment for Clinically Amyopathic Dermatomyositis at 4 Tertiary Care Centers JAMA DERMATOLOGY Pinard, J., Femia, A. N., Roman, M., Alsarheed, A., Joyce, C., Lin, J., Vleugels, R. 2019; 155 (4): 494?96
  • Systemic Treatment for Clinically Amyopathic Dermatomyositis at 4 Tertiary Care Centers. JAMA dermatology Pinard, J., Femia, A. N., Roman, M., Alsarheed, A., Joyce, C., Lin, J., Vleugels, R. A. 2019

    View details for PubMedID 30673076

  • 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis care & research Singh, J. A., Guyatt, G., Ogdie, A., Gladman, D. D., Deal, C., Deodhar, A., Dubreuil, M., Dunham, J., Husni, M. E., Kenny, S., Kwan-Morley, J., Lin, J., Marchetta, P., Mease, P. J., Merola, J. F., Miner, J., Ritchlin, C. T., Siaton, B., Smith, B. J., Van Voorhees, A. S., Jonsson, A. H., Shah, A. A., Sullivan, N., Turgunbaev, M., Coates, L. C., Gottlieb, A., Magrey, M., Nowell, W. B., Orbai, A., Reddy, S. M., Scher, J. U., Siegel, E., Siegel, M., Walsh, J. A., Turner, A. S., Reston, J. 2018

    Abstract

    OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF).METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations.RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment.CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

    View details for PubMedID 30499259

  • 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis & rheumatology (Hoboken, N.J.) Singh, J. A., Guyatt, G., Ogdie, A., Gladman, D. D., Deal, C., Deodhar, A., Dubreuil, M., Dunham, J., Husni, M. E., Kenny, S., Kwan-Morley, J., Lin, J., Marchetta, P., Mease, P. J., Merola, J. F., Miner, J., Ritchlin, C. T., Siaton, B., Smith, B. J., Van Voorhees, A. S., Jonsson, A. H., Shah, A. A., Sullivan, N., Turgunbaev, M., Coates, L. C., Gottlieb, A., Magrey, M., Nowell, W. B., Orbai, A., Reddy, S. M., Scher, J. U., Siegel, E., Siegel, M., Walsh, J. A., Turner, A. S., Reston, J. 2018

    Abstract

    OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF).METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations.RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment.CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

    View details for PubMedID 30499246

  • Tofacitinib Citrate for Refractory Cutaneous Dermatomyositis: An Alternative Treatment. JAMA dermatology Kurtzman, D. J., Wright, N. A., Lin, J., Femia, A. N., Merola, J. F., Patel, M., Vleugels, R. A. 2016

    View details for DOI 10.1001/jamadermatol.2016.0866

    View details for PubMedID 27120749

  • Comment on "the effects of bariatric surgery weight loss on knee pain in patients with osteoarthritis of the knee". Arthritis Lin, J., Parikh, M., Samuels, J. 2013; 2013: 517803-?

    View details for DOI 10.1155/2013/517803

    View details for PubMedID 23710356

  • The TNF alpha locus is altered in monocytes from patients with systemic lupus erythematosus CLINICAL IMMUNOLOGY Sullivan, K. E., Suriano, A., Dietzmann, K., Lin, J., Goldman, D., Petri, M. A. 2007; 123 (1): 74-81

    Abstract

    In systemic lupus erythematosus, TNFalpha is elevated in the serum and correlates with disease activity and triglyceride levels. The stimuli that drive TNFalpha in this setting are incompletely understood. This study was designed to evaluate monocyte chromatin at the TNFalpha locus to identify semi-permanent changes that might play a role in altered expression of TNFalpha. SLE patients with relatively quiescent disease (mean Physician Global Assessment=0.6) and healthy controls were recruited for this study. TNFalpha expression was measured by intracellular cytokine staining of different monocyte subsets in patients (n=24) and controls (n=12). Histone acetylation at the TNFalpha locus was measured by chromatin immunoprecipitation using a normalized quantitative PCR in patients (n=46) and controls (n=24). There were no differences in the overall fractions of cells expressing CD14 in SLE patients compared to controls; however, the fraction of DR+/CD16+ cells expressing CD14 was slightly higher as was true in the monocyte subset defined by DR+/CD11b+. Within the monocyte population defined by physical characteristics and DR+/CD14+, TNFalpha expressing cells were more frequent in SLE patients compared to controls. Both the fraction of positive cells and the mean fluorescence intensity were higher in patients than controls. Consistent with this was the finding that monocytes from patients had increased TNFalpha transcripts and more highly acetylated histones at the TNFalpha locus compared to controls. Furthermore, patients with the highest levels of TNFalpha histone acetylation were more likely to have had consistently elevated erythrocyte sedimentation rates, and to have required cytotoxic use. Histone acetylation, associated with increased transcriptional competence of TNFalpha, may play a role in certain inflammatory aspects of the disease.

    View details for DOI 10.1016/j.clim.2006.12.008

    View details for Web of Science ID 000245252600010

    View details for PubMedID 17276734

  • Renal biopsy in lupus patients with low levels of proteinuria JOURNAL OF RHEUMATOLOGY Christopher-Stine, L., Siedner, M., Lin, J., Haas, M., Parekh, H., Petri, M., Fine, D. M. 2007; 34 (2): 332-335

    Abstract

    Early and accurate detection of kidney involvement in systemic lupus erythematosus (SLE) improves outcomes. Renal biopsy is required for definitive diagnosis of lupus nephritis (LN). In the absence of acute renal failure (ARF), moderate levels of proteinuria (> 1000 mg/24 h) have been recommended by some to justify biopsy. We investigated whether patients with lower levels of proteinuria without ARF have significant renal disease and should be routinely biopsied.We retrospectively evaluated 21 SLE patients with 24-h urine protein < 1000 mg who underwent kidney biopsies. Indications for biopsy included new-onset proteinuria, increasing proteinuria, or hematuria (> 5 red blood cells per high power field). No patient had ARF.Sixteen of 21 (77%) biopsies were diagnostic of LN: 3 class II, 10 class III (5 superimposed class V), 2 class IV (one superimposed class V), and one with class V. One patient had thrombotic microangiopathy. The remaining 4 (23%) patients had non-lupus renal disease. Thirteen patients with class III or greater LN required alterations in therapeutic regimen because of biopsy findings. Of 7 patients without hematuria at the time of biopsy, 4 (57%) had class III, IV, or V LN. One patient without hematuria and < 500 mg/24 h proteinuria had class III LN.We found significant renal involvement (Class III, IV, or V LN) in SLE patients with < 1000 mg proteinuria with or without hematuria. Our findings suggest that biopsy be strongly considered in this patient population.

    View details for Web of Science ID 000244112900017

    View details for PubMedID 17183619

  • Risk factors for renal failure among 72 consecutive patients with rhabdomyolysis related to illicit drug use AMERICAN JOURNAL OF MEDICINE Fine, D. M., Gelber, A. C., Melamed, M. L., Lin, J. C., Lin, Z., Eustace, J. A. 2004; 117 (8): 607-610

    View details for DOI 10.1016/j.amjmed.2004.02.051

    View details for Web of Science ID 000224439300010

    View details for PubMedID 15465510

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