Physicians

Co-Chief, Division of Pediatric Rheumatology

Department / Division
Pediatrics / Pediatrics-Rheumatology

Address
DUMC 3212
Durham, NC 27710

Appointment Telephone
919-668-4000

Office Telephone
919-684-6575

Fax Telephone
919-684-6616

Training

• MD, Duke University School of Medicine, 1984

Residency

• Pediatrics, Duke University Medical Center, 1984-1987

Fellowship

• Pediatric Rheumatology, Duke University Medical Center, 1987-1991

Clinical Interests
Pediatric rheumatic diseases, pediatric systemic lupus erythematosus, pain in children with juvenile rheumatoid arthritis, musculoskeletal pain syndromes including juvenile fibromyalgia

Research Interests
I am involved in both hypothesis driven clinical research as well as clinical trials, both of which are described below.

My research team consists of health psychologists, medical fellows, and graduate students in clinical psychology. Most broadly, the research team has interests in studying stress and coping processes in children with chronic disease and their families. Particular interests include describing the pain experience of children with chronic arthritis and the role of parental processes in child adjustment to chronic disease.

The research team has several ongoing active research projects. These include a recently NIH funded study of daily pain in children with arthritis using an electronic device. This study is investigating the daily pain of children with arthritis in real time and their responses to pain, including activity and school function, as well as emotional regulation. In addition, parents will also record their responses to their child's pain in real time using a similar electronic device. We also continue data analysis of a paper diary study of stress, mood and disease activity in children with juvenile rheumatoid arthritis. A specific goal of the diary study is to determine the relationships of child daily ratings of stress and mood with measures of pain, physical disability, psychological distress, and worsening disease as measured clinically and with biological markers of disease and immune activation. This study is investigating the role of stress responsive hormones, such as prolactin and cortisol, and pain coping efficacy as mechanisms by which child stress and mood influence immune activation and worsening disease. Most recently we are engaged in developing a smart phone intervention to teach pain coping skills.

I am also active in the several clinic trials in pediatric rheumatology. I was the Principal Investigator for an NIH funded 21 center interventional trial entitled Prevention of Cardiovascular Complications of SLE: Atherosclerosis Prevention in Pediatric Lupus (APPLE) in conjunction with the Duke Clinical Research Institute (DCRI) and the Childhood Arthritis and Rheumatology Research Association (CARRA). This trial enrolled 221 children and adolescents with SLE and studied the efficacy and safety of statin therapy in children with SLE. The results were published this year. In addition, I am the DCRI Principal Investigator for the RAPPORT trial, a multicenter clinical trial studying the efficacy of rilonacept, a biologic agent that blocks interleukin 1 activity, in treating systemic-onset juvenile idiopathic arthritis. I lead the safety, data management, and data analysis aspects of RAPPORT. Enrollment for this trial has concluded and the results will be available in the coming year. As part of RAPPORT, we will be looking at the role of pain and disease symptoms as markers of response to medication, as well as more conventional outcome measures.

In addition, I am actively engaged with the CARRA network to develop infrastructure to make more pediatric rheumatology sites able to participate in clinical research, including the development of treatment protocols for all rheumatic diseases and a national registry of rheumatic disease to study medication safety and comparative effectiveness. This effort was jump started by a grant from the NIH as part of the American Recovery Act. The CARRA registry includes 60 CARRA sites and has enrolled 7700 children with rheumatic disease in the last 2 years. From this information, we hope to learn more about the outcomes of childhood rheumatic disease and establish best treatment practices.

Industry Relationships and Collaborations (What's this?)

This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• American College of Rheumatology
• Eli Lilly & Co.
• GlaxoSmithKline
• Novartis
• Roche
• UCB

Representative Publications
Bromberg, MH; Gil, KM; Schanberg, LE. Daily sleep quality and mood as predictors of pain in children with juvenile polyarticular arthritis. Health Psychology. 2012;31:202-209. (2012) Abstract

Connelly, M; Bromberg, MH; Anthony, KK; Gil, KM; Franks, L; Schanberg, LE. Emotion regulation predicts pain and functioning in children with juvenile idiopathic arthritis: an electronic diary study. Journal of Pediatric Psychology. 2012;37:43-52. (2012) Abstract

Mina, R; von Scheven, E; Ardoin, SP; Eberhard, BA; Punaro, M; Ilowite, N; Hsu, J; Klein-Gitelman, M; Moorthy, LN; Muscal, E; Radhakrishna, SM; Wagner-Weiner, L; Adams, M; Blier, P; Buckley, L; Chalom, E; Chédeville, G; Eichenfield, A; Fish, N; Henrickson, M; Hersh, AO; Hollister, R; Jones, O; Jung, L; Levy, D; Lopez-Benitez, J; McCurdy, D; Miettunen, PM; Quintero-del Rio, AI; Rothman, D; Rullo, O; Ruth, N; Schanberg, LE; Silverman, E; Singer, NG; Soep, J; Syed, R; Vogler, LB; Yalcindag, A; Yildirim-Toruner, C; Wallace, CA; Brunner, HI; Carra SLE Subcommittee. Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. Arthritis Care and Research. 2012;64:375-383. (2012) Abstract

Schanberg, LE; Sandborg, C; Barnhart, HX; Ardoin, SP; Yow, E; Evans, GW; Mieszkalski, KL; Ilowite, NT; Eberhard, A; Imundo, LF; Kimura, Y; von Scheven, E; Silverman, E; Bowyer, SL; Punaro, M; Singer, NG; Sherry, DD; McCurdy, D; Klein-Gitelman, M; Wallace, C; Silver, R; Wagner-Weiner, L; Higgins, GC; Brunner, HI; Jung, L; Soep, JB; Reed, AM; Provenzale, J; Thompson, SD; Atherosclerosis Prevention in Pediatric Lupus Erythematosus Investigators. Use of atorvastatin in systemic lupus erythematosus in children and adolescents. Arthritis and Rheumatism. 2012;64:285-296. (2012) Abstract

Wallace, CA; Giannini, EH; Spalding, SJ; Hashkes, PJ; O'Neil, KM; Zeft, AS; Szer, IS; Ringold, S; Brunner, HI; Schanberg, LE; Sundel, RP; Milojevic, D; Punaro, MG; Chira, P; Gottlieb, BS; Higgins, GC; Ilowite, NT; Kimura, Y; Hamilton, S; Johnson, A; Huang, B; Lovell, DJ; Childhood Arthritis and Rheumatology Research Alliance. Trial of early aggressive therapy in polyarticular juvenile idiopathic arthritis. Arthritis and Rheumatism. 2012;64:2012-2021. (2012) Abstract

Brunner, HI; Klein-Gitelman, MS; Higgins, GC; Lapidus, SK; Levy, DM; Eberhard, A; Singer, N; Olson, JC; Onel, K; Punaro, M; Schanberg, L; von Scheven, E; Ying, J; Giannini, EH. Toward the development of criteria for global flares in juvenile systemic lupus erythematosus. Arthritis Care and Research. 2010;62:811-820. (2010) Abstract

Connelly, M; Anthony, KK; Sarniak, R; Bromberg, MH; Gil, KM; Schanberg, LE. Parent pain responses as predictors of daily activities and mood in children with juvenile idiopathic arthritis: the utility of electronic diaries. Journal of Pain and Symptom Management. 2010;39:579-590. (2010) Abstract

Ross, GS; Zelko, F; Klein-Gitelman, M; Levy, DM; Muscal, E; Schanberg, LE; Anthony, K; Brunner, HI; Childhood Arthritis & Rheumatology Research Alliance Ad-Hoc Neurocognitive Lupus Committee. A proposed framework to standardize the neurocognitive assessment of patients with pediatric systemic lupus erythematosus. Arthritis Care and Research. 2010;62:1029-1033. (2010) Abstract

Levy, DM; Ardoin, SP; Schanberg, LE. Neurocognitive impairment in children and adolescents with systemic lupus erythematosus. Nature Clinical Practice Rheumatology. 2009;5:106-114. (2009) Abstract

Schanberg, LE; Sandborg, C; Barnhart, HX; Ardoin, SP; Yow, E; Evans, GW; Mieszkalski, KL; Ilowite, NT; Eberhard, A; Levy, DM; Kimura, Y; von Scheven, E; Silverman, E; Bowyer, SL; Punaro, L; Singer, NG; Sherry, DD; McCurdy, D; Klein-Gitelman, M; Wallace, C; Silver, R; Wagner-Weiner, L; Higgins, GC; Brunner, HI; Jung, L; Soep, JB; Reed, A; Atherosclerosis Prevention in Pediatric Lupus Erythematosus Investigators. Premature atherosclerosis in pediatric systemic lupus erythematosus: risk factors for increased carotid intima-media thickness in the atherosclerosis prevention in pediatric lupus erythematosus cohort. Arthritis and Rheumatism. 2009;60:1496-1507. (2009) Abstract

Sandborg, C; Ardoin, SP; Schanberg, L. Therapy Insight: cardiovascular disease in pediatric systemic lupus erythematosus. Nature Clinical Practice Rheumatology. 2008;4:258-265. (2008) Abstract

Anthony, KK; Schanberg, LE. Assessment and management of pain syndromes and arthritis pain in children and adolescents. Rheumatic Disease Clinics of North America. 2007;33:625-660. (2007) Abstract

Ardoin, SP; Sandborg, C; Schanberg, LE. Management of dyslipidemia in children and adolescents with systemic lupus erythematosus. Lupus. 2007;16:618-626. (2007) Abstract

Kimura, Y; Walco, GA; Sugarman, E; Conte, PM; Schanberg, LE. Treatment of pain in juvenile idiopathic arthritis: a survey of pediatric rheumatologists. Arthritis and Rheumatism. 2006;55:81-85. (2006) Abstract

Ardoin, SP; Schanberg, LE. The management of pediatric systemic lupus erythematosus. Nature Clinical Practice Rheumatology. 2005;1:82-92. (2005) Abstract

Schanberg, LE; Gil, KM; Anthony, KK; Yow, E; Rochon, J. Pain, stiffness, and fatigue in juvenile polyarticular arthritis: contemporaneous stressful events and mood as predictors. Arthritis and Rheumatism. 2005;52:1196-1204. (2005) Abstract

Sandstrom, MJ; Schanberg, LE. Peer rejection, social behavior, and psychological adjustment in children with juvenile rheumatic disease. Journal of Pediatric Psychology. 2004;29:29-34. (2004) Abstract

Schanberg, LE; Sandborg, C. Dyslipoproteinemia and premature atherosclerosis in pediatric systemic lupus erythematosus. Current Rheumatology Reports. 2004;6:425-433. (2004) Abstract

Anthony, KK; Gil, KM; Schanberg, LE. Brief report: Parental perceptions of child vulnerability in children with chronic illness. Journal of Pediatric Psychology. 2003;28:185-190. (2003) Abstract

Anthony, KK; Schanberg, LE. Pain in children with arthritis: a review of the current literature. Arthritis and Rheumatism. 2003;49:272-279. (2003) Abstract

Schanberg, LE. Widespread pain in children: when is it pathologic?. Arthritis and Rheumatism. 2003;48:2402-2405. (2003) Abstract

Schanberg, LE; Anthony, KK; Gil, KM; Maurin, EC. Daily pain and symptoms in children with polyarticular arthritis. Arthritis and Rheumatism. 2003;48:1390-1397. (2003) Abstract

Schanberg, LE; Anthony, KK; Gil, KM; Lefebvre, JC; Kredich, DW; Macharoni, LM. Family pain history predicts child health status in children with chronic rheumatic disease. Pediatrics. 2001;108:E47. (2001) Abstract

Schanberg, LE; Sandstrom, MJ; Starr, K; Gil, KM; Lefebvre, JC; Keefe, FJ; Affleck, G; Tennen, H. The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease. Arthritis and Rheumatism. 2000;13:33-41. (2000) Abstract

Schanberg, LE; Keefe, FJ; Lefebvre, JC; Kredich, DW; Gil, KM. Social context of pain in children with Juvenile Primary Fibromyalgia Syndrome: parental pain history and family environment. Clinical Journal of Pain. 1998;14:107-115. (1998) Abstract

Schanberg, LE; Lefebvre, JC; Keefe, FJ; Kredich, DW; Gil, KM. Pain coping and the pain experience in children with juvenile chronic arthritis. Pain. 1997;73:181-189. (1997) Abstract

Schanberg, LE; Keefe, FJ; Lefebvre, JC; Kredich, DW; Gil, KM. Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress. Arthritis and Rheumatism. 1996;9:89-96. (1996) Abstract