About

Joyce C. Chang, MD, MSCE, is an Adjunct Assistant Professor of Pediatrics (Rheumatology) at the Perelman School of Medicine at the University of Pennsylvania. She is affiliated with Boston Children's Hospital. Her educational background includes an AB in Biochemical Sciences from Harvard College obtained in 2008, an MD from the University of Pennsylvania, Perelman School of Medicine, earned in 2012, and a Master of Science in Clinical Epidemiology (MSCE) from the same institution completed in 2018. Her research and clinical interests focus on pediatric rheumatology, autoimmune diseases, and the application of clinical epidemiology to improve outcomes in pediatric patients with systemic autoimmune conditions. She has contributed to studies on eosinophilia, lung disease in systemic juvenile idiopathic arthritis, multisystem inflammatory syndrome in children due to COVID-19, and pediatric lupus, among others.

Research topics

• Internal medicine
• Medicine
• Pediatrics

Selected publications

• Fronto-cerebellar features associate with cognitive dysfunction in childhood-onset systemic lupus erythematosus

  Seminars in Arthritis and Rheumatism · 2026-01-11

  articleOpen accessCorresponding
  PublisherOA PDFDOI

• Clinically validated assay for rapid determination of type I and type II interferon activity in systemic inflammatory diseases

  Journal of Allergy and Clinical Immunology · 2026-02-01 · 1 citations

  article
  PublisherDOI

• Fronto-Cerebellar Features Associate with Cognitive Dysfunction in Childhood-Onset Systemic Lupus Erythematosus

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Endomyocardial Fibrosis Mimicking a Heart Tumor and Dysplastic Tricuspid Valve in a Teenager: A Rare Cardiac Manifestation of Behçet Disease

  Circulation Cardiovascular Imaging · 2025-03-04

  article
  PublisherDOI

• Sex Differences in B Cells from the Joints of Children with Oligoarticular Juvenile Idiopathic Arthritis

  immuneACCESS · 2025-03-18

  dataset
  PublisherDOI

• A Qualitative Exploration of Adherence to Methotrexate in Juvenile Idiopathic Arthritis

  The Journal of Pediatrics · 2025-08-29 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• Long-term safety of canakinumab in patients with systemic juvenile idiopathic arthritis: 5-year results from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry

  Pediatric Rheumatology · 2025-10-21 · 1 citations

  articleOpen accessCorresponding

  BACKGROUND: Systemic juvenile idiopathic arthritis (SJIA) is a severe form of juvenile idiopathic arthritis characterized by fever, rash, chronic arthritis, and systemic inflammation. The introduction of biologics has improved the treatment options for SJIA. Canakinumab selectively inhibits interleukin-1β and is approved for SJIA treatment. In this study that utilized the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry, long-term safety data available from patients with SJIA who started either canakinumab treatment or an alternative therapy were assessed. METHODS: This long-term, prospective, non-interventional study was conducted from August 2015 to June 2022 using data from the CARRA Registry. Data for serious adverse events (SAEs) and pre-specified events of special interest (ESIs) were collected from patients with SJIA aged between ≥ 2 and < 18 years at the time of treatment initiation and followed for a minimum of 5 years. Data were summarized descriptively, and no hypothesis testing was performed. RESULTS: The final analysis included 177 patients: 90 in the overall canakinumab group (incident users [N = 39] and prevalent users [N = 51]) and 87 in the alternative treatment group. Median patient age at treatment initiation was 8.0 years in the overall canakinumab group. The incidence rates of SAEs per 100 patient-years were 3.62 (overall canakinumab group) and 3.39 (canakinumab incident users group). Of the predefined ESIs, macrophage activation syndrome (n = 5) and infections treated with intravenous anti-infectives (n = 1) were observed in the overall canakinumab group. The majority of patients (72.2%) treated with canakinumab received on-label dosing at some point during the first 5 years of the study. CONCLUSIONS: Overall, no changes were observed in the safety profile with long-term use of canakinumab in pediatric patients with SJIA. Particularly, no change in the frequency or severity of known ESIs occurred, and no new risks were identified. The findings suggest that canakinumab is effective in SJIA management and has a favorable safety profile with long-term use over a period of 5 years in real-world settings.

  PublisherOA PDFDOI

• Hypertension, proteinuria, and RAAS inhibition use in children with systemic lupus erythematosus: Data from a multi-institutional pediatric learning health system

  Lupus · 2025-05-20 · 2 citations

  articleOpen access1st authorCorresponding

  Objectives To assess the potential of a multi-institutional pediatric learning health system for comparative effectiveness research in pediatric-onset systemic lupus erythematosus (SLE), we characterized renin angiotensin aldosterone system (RAAS) inhibitor utilization and the feasibility of ascertaining key treatment indications and outcomes, including hypertension and proteinuria. Methods We identified children with SLE and lupus nephritis (LN) at 6 PEDSnet institutions using previously developed computable phenotypes. A reference population of controls without SLE was randomly sampled from the same rheumatology/nephrology clinics ( N = 200 controls per site). We evaluated data completeness, plausibility, and conformance related to RAAS inhibitor treatment indications and outcomes: (a) percent of encounters with blood pressure (BP) readings, (b) percent of BP readings with paired height, (c) percent of patients with ≥1 urinalysis within 7 days of SLE diagnosis, (d) urinalyses for which proteinuria could be classified as normal or abnormal, and (e) RAAS inhibitor use. Results There were 1303 patients with SLE, including 457 with LN. BP measurements were available at 62% of encounters, of which 96% were paired with a height within 90 days. BP distributions were higher in patients with SLE and LN compared to controls without SLE. One third of SLE patients had a hypertension diagnosis. 60%–83% of patients at each site had a urinalysis protein measurement within 7 days of SLE diagnosis. A normal or abnormal result for proteinuria could be derived for 96% of measurements, and nearly all patients with LN had ≥1 abnormal result (range 94%–100% by site). RAAS inhibitors were prescribed to 31% of SLE and 71% of LN patients (range 60%–84% by site). Hypertension, elevated BP or proteinuria was identified in 90% of SLE cases at the time of RAAS inhibitor initiation. Conclusion We demonstrated the feasibility of ascertaining health measurement data relevant to pediatric lupus treatment and outcomes in a pediatric learning health system, as well as hospital-level variation in RAAS inhibitor use. This work will facilitate more efficient multi-institutional comparative effectiveness research and also highlights opportunities for increased treatment standardization.

  PublisherOA PDFDOI

• Using a multi-institutional pediatric learning health system to characterize induction therapy for incident lupus nephritis in children

  Pediatric Nephrology · 2025-12-01

  article
  PublisherDOI

• Sex Differences in B Cells From the Joints of Children With Oligoarticular Juvenile Idiopathic Arthritis

  Arthritis & Rheumatology · 2025-03-18

  articleOpen access

  OBJECTIVE: Disordered T peripheral helper (Tph)-B cell interactions have been implicated in several forms of inflammatory arthritis, including oligoarticular (oligo) juvenile idiopathic arthritis (JIA). We sought to evaluate the Tph-B cell axis in oligo JIA through an analysis of intra-articular B cells. METHODS: B cells from the blood and synovial fluid (SF) of 44 children with oligo JIA were compared to those from the blood and tonsils of controls. Flow cytometry, B cell receptor (BCR) repertoire analysis, and autoantibody profiling were used to characterize B cells. RESULTS: B cells were enriched in oligo JIA-SF versus blood of patients and controls. Compared to male patients, female patients with oligo JIA had greater proportions of intra-articular Tph cells that expressed B cell help factors as well as Bmem cells, plasmablasts, and age-/autoimmune-associated B cells. The sex differences in B cells were observed only in the joints and were not found in the blood or tonsil, nor were they explained by other disease features such as age at onset, antinuclear antibody status, or severity. Bmem cells in SF from female patients displayed characteristics of autoreactivity, including longer complementarity determining region 3 lengths and increased usage of autoreactive BCR gene segments, which were not found in blood Bmem cells. A diverse array of autoantibodies accumulated in the SF of female patients with oligo JIA compared to the blood of patients with JIA and controls. CONCLUSION: These findings demonstrate prominent B cell dysregulation in oligo JIA and implicate sex as an important biologic factor in B cell responses in this disease.

  PublisherOA PDFDOI

Recent grants

• Cardiac inflammation and precursors of damage in youth with systemic lupus erythematosus

  NIH · $71k · 2018–2019

• Cardiovascular health assessment & outcomes of systemic lupus erythematosus: bridging pediatric and adult- onset disease

  NIH · $973k · 2020–2025

Frequent coauthors

• Andrea Knight

  University of Toronto

  136 shared

• Pamela F. Weiss

  Children's Hospital of Philadelphia

  112 shared

• Rui Xiao

  Nanchang University

  84 shared

• Kevin Meyers

  66 shared

• Shobha Natarajan

  University of Pennsylvania

  66 shared

• Mary Beth F. Son

  Boston Children's Hospital

  60 shared

• Peter A. Nigrović

  Boston Children's Museum

  43 shared

• Esra Meidan

  Harvard University

  41 shared

Education

• MSCE

  University of Pennsylvania Perelman School of Medicine

  2018

• MD

  University of Pennsylvania Perelman School of Medicine

  2012