Jordan Roberts, MD
2021 Recipient, Gary S. Gilkeson Career Development Award
Boston Children’s Hospital
Title of Project: Assessing the Impact of Immunosuppressants on Infections in Pediatric Lupus
Mentor: Mary Beth Son, MD
About the Researcher
Jordan Roberts, MD, first became interested in lupus as a medical student at Weill Cornell Medical College, where she received a research fellowship to investigate hip replacement outcomes in patients with lupus. She had the opportunity to present her work at the American College of Rheumatology meeting and was also the first author on a paper about these findings published in the Journal of Rheumatology. Dr. Roberts was inspired by the opportunity to use her findings to directly improve care for patients with lupus, which motivated her to pursue rheumatology and clinical research as a career.
Dr. Roberts ultimately chose to specialize in pediatric rheumatology due to the opportunities in pediatric rheumatology to care for children of different ages and developmental stages, and to support their families through challenging times such as a hospitalization or a new diagnosis. As a resident at Boston Children’s Hospital, Dr. Roberts cared for many children with autoimmune diseases, including patients with lupus nephritis who dramatically improved after starting treatment. However, upon seeing the difficult impact of side effects from treatments like high-dose steroids, and as she learned more about lupus, she was struck by how much more there is to learn about the disease and the best treatments, particularly in children and adolescents.
Currently, Dr. Roberts is a third-year fellow in Pediatric Rheumatology at Boston Children’s Hospital. She is also a second-year fellow in the Harvard-Wide Pediatric Health Services Research Fellowship and is completing a Master of Public Health in Clinical Effectiveness at the Harvard T.H. Chan School of Public Health in order to gain skills as a clinical researcher. Dr. Roberts previously studied increasing doses of biologic medications in children with difficult to treat uveitis, a type of eye inflammation, and recently published this work in the Journal of Clinical Rheumatology. She is also working to improve the process for transitioning adolescent patients to adult care and received a Boston Children’s Hospital grant for this work, which was recently published in Pediatric Rheumatology.
Most recently, Dr. Roberts has focused her research efforts on studying which treatments children with lupus receive, with the goal of understanding why variation exists and whether factors such as race, ethnicity, or family education and income impact choice of medications. Her preliminary work showed substantial variation in medication use among pediatric lupus patients, and differences in medication selection by race and insurance status.
Dr. Roberts is highly committed to a career in clinical research in pediatric lupus. Her overall goal is to understand which medications for lupus are most safe and effective in children and identify ways to reduce disparities in outcomes to improve the health of all children with lupus. With this work, she hopes to advance understanding of infections in pediatric lupus and how they are related to different immunosuppressant medications to provide clinicians with better evidence on which to base treatment decisions.
Children with lupus are at increased risk of infection, both because of the impact that lupus has on the body’s immune system and its ability to fight infections, and because of the medications used to treat lupus. Most prior studies of infections in lupus are in adult patients, who have different risks for infections and underlying illnesses. Children also tend to have more severe lupus than adults and may be treated with more medications that can suppress the immune system. Despite this, we have very little data on infections in children with lupus. As such, pediatric rheumatologists are limited in their ability to choose the safest and most effective medication regimens for their patients.
Our goals in this study are to better understand the burden of serious infections requiring hospitalization or emergency department visits in children with lupus, and to understand how certain medications used to treat lupus increase the risk of infections in order to provide clinicians with better information to select the safest treatments. To accomplish this, we will use a large national database to study the number of hospitalizations and emergency department visits for infections in children with lupus, and the specific types of infections that children with lupus get. Using medical records from our center, we will compare the odds of developing a serious infection among children treated with different types of immunosuppressant medications. We will adjust for patient characteristics like lupus severity and simultaneous use of multiple medications in order to understand how each medication impacts the risk of infection.
Through this work, we will further our understanding of serious infections in children with lupus and how this is increased by specific immunosuppressive medications. We anticipate that these results will provide essential information to help pediatric rheumatologists select the safest medications for children with lupus.