About

John W. Rose, MD, is the Neuroimmunology & Autoimmune Neurology Division Chief and Professor of Neurology at the University of Utah. He is also the chief of neurology at the Salt Lake City Veterans Administration Hospital. Dr. Rose and his colleagues investigate diverse aspects of multiple sclerosis (MS), including the immunopathology of MS and related models, the development of new treatments for MS, early disease detection with advanced magnetic resonance imaging, and the detection of susceptibility genes for MS. His focus is on multiple sclerosis clinical care and research, with ongoing clinical investigations of neurogenic pain, optical coherence tomography (OCT), and immunotherapies. A special area of his research is Pediatric Multiple Sclerosis, including clinical and translational investigations, as well as the development of Magnetic Resonance Imaging techniques for detection of demyelination and remyelination. Dr. Rose's clinical practice is a Partner in Care with the National Multiple Sclerosis Society and is designated a Comprehensive Care Center, emphasizing his commitment to comprehensive MS care and research.

Research topics

• Medicine
• Internal medicine
• Radiology
• Pediatrics
• Psychiatry
• Pathology
• Nuclear medicine
• Nuclear magnetic resonance
• Physics
• Immunology
• Anatomy
• Neuroscience
• Surgery
• Physical therapy
• Family medicine
• Biology
• Gastroenterology

Selected publications

• Limited early IVIG for the treatment of pediatric myelin oligodendrocyte glycoprotein antibody-associated disease

  Multiple Sclerosis and Related Disorders · 2025-03-10 · 3 citations

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  PublisherDOI

• Transverse Myelitis in Context: Investigating the Role of Social Determinants of Health (SDOH) in Clinical Outcomes at a Population Level (P8-8.008)

  Neurology · 2025-04-07

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  Understand the impact of social determinants of health (SDOH) in the clinical outcomes of transverse myelitis (TM).

  PublisherDOI

• Epigenetic age and telomere length correlations in pediatric-onset multiple sclerosis

  Multiple Sclerosis Journal · 2025-11-06

  articleOpen access

  Background: Age is the strongest factor determining disease expression in multiple sclerosis (MS). We previously demonstrated biological age acceleration in pediatric-onset MS (POMS) compared to controls with both epigenetic clocks (DNAm) and telomere length (TL). It is unknown whether these markers report overlapping or distinct aging-related processes. Objectives: To determine the correlation between DNAm and TL aging markers. Methods: We conducted a cross-sectional case–control study within the US Network of Pediatric MS Centers. We calculated age acceleration residuals for the Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks and measured TL from whole blood samples to estimate telomere to somatic DNA ratios (T/S ratio). We employed multivariable analysis of covariance to assess the correlation between DNAm estimates and TL. Results: We analyzed biological ages in 270 participants (125 POMS, mean 15.7 years; 145 controls, mean 15.3 years). There were moderate correlations among the different DNAm clocks, but no correlations between DNAm clocks and TL in pooled analyses. In a stratified analysis, only the control group showed a modest correlation between TL and PhenoAge clock ( r = 0.2, p = 0.06). Conclusions: DNAm did not correlate with TL in this sample of POMS and controls, suggesting that these biomarkers may capture complementary and non-overlapping elements of aging-related biology.

  PublisherDOI

• Real‐World Effectiveness of Switching to Oral or Infusion Versus Injectable Disease‐Modifying Therapy in Pediatric Multiple Sclerosis

  Annals of Neurology · 2025-11-06 · 1 citations

  articleOpen access

  OBJECTIVE: To assess real-world effectiveness of switching disease-modifying therapy (DMT) in pediatric multiple sclerosis (MS) and clinically isolated syndrome (CIS) initially treated with platform injectables on disease activity. METHODS: Of 2615 pediatric-onset demyelinating disease patients at 12 clinics in the United States (US) Network of Pediatric MS Centers, those with MS/CIS on initial therapy with a platform injectable who switched to another class of platform injectable, oral or infusion DMT were analyzed. Relapse rate was modeled with negative binomial regression, adjusted for preidentified confounders. RESULTS: A total of 212 children switched DMT before age 18 (67% female, 95% MS). Ninety-three switched from injectable to injectable, 76 injectable to oral, and 43 injectable to infusion. Switchers to oral or infusion were older at onset (injectable 12.3 years, oral 13.5 years, and infusion 14.2 years) and switch (injectable 14.6 years, oral 16.0 years, and infusion 15.7 years). Switchers to infusion DMT were more likely to have enhancing lesions (injectable 45%, oral 28%, and infusion 67%). Compared to injectable (annualized relapse rate [ARR] = 0.88, 95% confidence interval [CI] = 0.52-1.48), relapse rates were lower for injectable to oral (ARR = 0.34, 95% CI = 0.20-0.57; rate ratio: 0.38, 95% CI = 0.21-0.69) and injectable to infusion (ARR = 0.18, 95% CI = 0.09-0.37; rate ratio: 0.21, 95% CI = 0.10-0.44) (p < 0.001). Adjusted number needed to treat in person-years to prevent 1 relapse with oral over injectable was 1.84 (95% CI = 1.03-8.69) and infusion over injectable 1.43 (95% CI = 1.00-3.88). INTERPRETATION: Switching from platform injectable to oral or infusion compared to other platform injectable DMT led to better disease control in pediatric MS. Long-term safety data are required. ANN NEUROL 2026;99:715-729.

  PublisherOA PDFDOI

• Prolonged corticosteroid therapy and steroid-sparing maintenance immunotherapy lower relapse risk in pediatric and adult MOGAD

  Journal of Neuroimmunology · 2025-07-30 · 3 citations

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  PublisherDOI

• Allele-specific vitamin D receptor binding is associated with pediatric-onset multiple sclerosis

  Multiple Sclerosis Journal - Experimental Translational and Clinical · 2025-04-01

  articleOpen access

  Background and Objectives: The genetic basis of adult-onset multiple sclerosis (MS) is well-studied, but less is known about pediatric-onset MS (pedMS), comprising approximately 5% of all MS onsets. Mendelian randomization (MR) studies have demonstrated evidence for a causal association between MS and both 25-hydroxyvitamin D [25(OH)D] serum levels and genetic variation related to vitamin D receptor (VDR) binding. The objective was to identify whether VDR binding variants (VDR-BVs) previously implicated in adult-onset MS were associated with pedMS using genetic instrumental variables (GIVs). Methods: Using previously identified VDR-BVs to construct individual GIVs with two-sample MR, we investigated associations with pedMS in 725 cases and 592 controls of European ancestry from the US Network of Pediatric MS Centers. Associations between each VDR-BV and pedMS were estimated using logistic regression adjusting for the first three genome-wide principal components. A significant interaction between a VDR-BV and 25(OH)D GIV provided evidence for a causal association unbiased by pleiotropy. Results: One VDR-BV, rs2531804, previously associated with adult-onset MS, was also significantly associated with pedMS after multiple testing correction. Discussion: This study is the first to use VDR-BVs from previous MR studies to demonstrate causal differences in VDR binding at a locus contributing to pedMS susceptibility.

  PublisherDOI

• 3-in-one PD-1CAR Tregs: A bioengineered cellular therapy for target engagement, activation, and immunosuppression with reparative potential

  iScience · 2025-10-04 · 1 citations

  articleOpen access

  CAR Tregs as a unique therapy with both targeted suppression and tissue repair potential.

  PublisherDOI

• Epigenetic Age is Minimally Correlated with Leukocyte Telomere Length in Pediatric Onset Multiple Sclerosis (P6-1.005)

  Neurology · 2025-04-07

  article

  To determine the correlation between epigenetic clocks and telomere length in pediatric-onset MS (POMS) participants and age-similar pediatric controls.

  PublisherDOI

• Medicare Part D Use and Costs for Immune-Mediated Neurologic Therapies

  JAMA Network Open · 2025-10-20

  articleOpen access

  Importance: The expansion in the number of disease-modifying therapies (DMTs) for immune-mediated neurologic diseases raises critical questions about trends in their use and cost over time and whether this growth could be contributing to escalating financial burdens within the Medicare system. Objective: To examine trends in claims and Medicare Part D payments for DMTs for immune-mediated neurologic diseases. Design and Setting: This retrospective economic evaluation analyzed Medicare Part D Prescriber Public Use Files from January 1, 2013, to December 31, 2022, restricting to prescription drug claims categorized under the clinician-defined neurology taxonomy. Only prescription drugs used as DMTs for multiple sclerosis, neuromyelitis optica spectrum disorder, and other immune-mediated neurologic disorders were included. To ensure accuracy, these medications were validated by 2 pharmacists. The data were analyzed between October 1, 2023, and November 12, 2024. Main Outcomes and Measures: Ten-year trends in total payments, number of claims, and payment per claim for DMTs were assessed for their contribution to overall cost increases. Inflation adjustments were applied using both medical care-specific and prescription drug-specific indices. Results: Between 2013 and 2022, 63 unique drugs used as DMTs for multiple sclerosis, neuromyelitis optica spectrum disorder, and other immune-mediated neurologic disorders (eg, autoimmune encephalitis, myasthenia gravis) accounted for 6 526 278 claims and contributed $35 billion in Medicare drug expenditures. Between 2013 and 2022, annual claims for DMTs increased by 3.8% (from 549 766 to 570 298 claims). However, total payments for DMTs saw a disproportionate increase of 70.3% (95% CI, 13.5%-130.3%) from 2013 to 2022. After adjusting for medical care or prescription drug inflation, 2022 payments per claim increased by 29.1% (95% CI, 15.6% to 51.6%) and 35.9% (95% CI, 29.5%-50.3%), respectively, indicating that the rise in drug costs exceeded adjustments for medical care or prescription drug inflation rates. For the 29 DMTs available over the entire 10-year period, total claims decreased by 14.8% (from 546 026 to 465 089). Despite this reduction in claims, total payments increased by 60.5% (95% CI, 50.9%-90.6%). After adjusting for medical care inflation, the total payment increased significantly by 26.2% (95% CI, 10.5%-49.4%). Conclusions and Relevance: Over the past decade, Medicare Part D expenditures for DMTs targeting immune-mediated neurologic diseases have increased substantially, despite relatively stable claim volumes. These findings show that increases have consistently outpaced inflation rates, adding substantial economic pressure to federally funded neurologic care.

  PublisherOA PDFDOI

• Novel MRI techniques for the Assessment of Activated Innate Immunity in Progressive Multiple Sclerosis

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2024-08-14

  article

  While the specific pathologic mechanisms that underpin ongoing axonal loss in progressive forms of MS are not fully characterized, ongoing innate immune activation in chronic MS lesions, particularly activated microglia and macrophages, has been proposed to be a prevailing mechanism of axonal loss in the progressive phase of disease. Ultrasmall superparamagnetic iron oxide particles have been introduced as a potential MRI biomarker for macrophage activity in focal MS lesions. This work presents a Feromoxytol enhanced MRI to measure perilesional activated microglia and macrophages in progressive MS. which is anticipated to reflect risk for ongoing loss of CNS axons and neurons.

  PublisherDOI

Recent grants

• NIH Grant R01NS013748

  NIH · $996k · 1995

Frequent coauthors

• Tanuja Chitnis

  Massachusetts General Hospital

  1067 shared

• Mark Gorman

  1057 shared

• Lauren Krupp

  Boston Children's Hospital

  1047 shared

• Emmanuelle Waubant

  Massachusetts General Hospital

  1044 shared

• Moses Rodriguez

  Mayo Clinic

  1042 shared

• Bianca Weinstock‐Guttman

  Williams (United States)

  1039 shared

• Jennifer Graves

  Stanford University

  1031 shared

• Soe Mar

  Massachusetts General Hospital

  1025 shared