Jon M Burnham
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1993–2026
About
Jon M Burnham, MD, MSCE, is a Professor of Pediatrics (Rheumatology) at the Children's Hospital of Philadelphia, affiliated with the Department of Pediatrics. His educational background includes a BA in Government from Dartmouth College, obtained in 1992, and an MD from the University of Pennsylvania School of Medicine, completed in 1997. He further earned an MSCE in Clinical Epidemiology and Biostatistics from the University of Pennsylvania School of Medicine in 2006. His professional focus is on pediatric rheumatology, with a particular emphasis on improving outcomes for children with rheumatic diseases. His work involves clinical research, including telehealth triage in pediatric rheumatology, assessment of medication adherence in juvenile idiopathic arthritis, and the development of treatment strategies for childhood-onset systemic lupus erythematosus. Dr. Burnham has contributed to advancing collaborative learning health system approaches to enhance disease activity outcomes and reduce disparities in pediatric rheumatology care.
Research topics
- Medicine
- Internal medicine
- Endocrinology
- Physical therapy
- Pediatrics
Selected publications
2026-03-01
articleOpen accessBlood · 2025-11-03
articleAbstract Introduction: Autologous CD19 CART therapies have been utilized across a wide range of B cell driven autoimmune diseases (AD), including systemic lupus erythematous (SLE), idiopathic inflammatory myopathies (IIM), systemic sclerosis (SSc), & myasthenia gravis (MG). To date, a number of autologous CD19-CART therapies have delivered durable drug free responses in AD patients. However, the safety profile of autologous CD19-CART therapies across different AD has yet to be fully explored. This is especially true for CRS & ICANS. Here, we provide novel insight into the mechanism underlying the safety profile of resecabtagene autoleucel (rese-cel) an autologous CD19 41BBz CART therapy across four separate Phase I/II clinical trials in SLE, IIM, SSc, & MG. Objectives: The primary objective of each trial is safety & tolerability of rese-cel at Day 29. Key secondary objectives include changes in clinical scores & use of immunomodulatory agents. Key translational assessments include CART cell pharmacokinetics (PK), impact on peripheral B cell populations (pharmacodynamics), & serum cytokine levels. Methods: 19 Patients (data cutoff: 6/2/2025 SLE; 5/6/2025 IIM, SSc, and MG), with active disease refractory to standard of care have been treated across 4 Phase I/II clinical trials in SLE (8 patients; NCT06121297), IIM (8 patients; NCT06154252), SSc (2 patients; NCT06328777), & MG (1 patient; NCT06359041). All patients were treated with a single weight-based infusion of rese-cel at a dose of 1 x 106 cells/kg following lymphodepletion (flu 25 mg/m2/d on Days -5, -4, & -3, & cy 1,000 mg/m2/d on Day -3). All non-glucocorticoid immunomodulatory agents were stopped prior to lymphodepletion. Glucocorticoids were tapered post-infusion. Patients were not given prophylactic tocilizumab pre-infusion. Translational assessments were determined as follows: CART PK was evaluated by flow cytometry & dPCR; B-cell enumeration & phenotyping were evaluated by flow cytometry; & serum cytokines were evaluated via immunoassay. Results: Across all indications (19 patients), 7 episodes of CRS were observed (7/19). 6 of 7 patients experienced a Grade 1 CRS, & 1 patient had a Grade 2 CRS. 2 patients developed ICANS; 1 patient had a Grade 4 (previously presented at ACR Convergence 2024), & the other patient had a Grade 3. Both ICANS events were rapidly resolved without sequelae using standard therapy. These CRS and ICANS events differed across indications. In IIM, 4 of 8 patients experienced Grade 1 CRS and no patients experienced ICANs. In SLE, 2 patients experienced Grade 1 CRS and one developed Grade 4 ICANs. In SSC, 1 of 2 patients experienced Grade 2 CRS & the other experienced Grade 3 ICANS. In MG, no CRS or ICANS was observed. Rese-cel infusion products were ~ 66% transduced, with a mean CD4:CD8 ratio of 6. Post-infusion, peak CART expansion was observed on day 12 & the mean peak expansion was 89 cells/µL (SD +/- 214). B cells were rapidly depleted from peripheral blood post-infusion, with nadir occurring at 13 days & repopulation beginning at 62 days post-infusion on average. Re-emergent B cells were largely of the CD24+CD38+ transitional naïve phenotype. Commensurate with B cell depletion, serum BAFF induction was observed, with a mean fold induction of 16 & mean peak level of 56,404 pg/µL (SD: +/- 45,547). Serum cytokines associated with CRS & ICANS; IFNg, IL6, & IL8 reached peak elevation on days 10, 9, & 10 respectively post-infusion. The mean peak elevation for IFNg, IL6, & IL8 were 232 pg/ µL (SD: +/- 320), 44 pg/ µL (SD: +/- 60), & 80 pg/ µL (SD +/- 73), respectively. Conclusion: Rese-cel appears to be well tolerated in autoimmune patients with rates of CRS & ICANS of 37% & 11% across all autoimmune indications, respectively (SLE patients had a 25% CRS rate & 12.5% ICANS rate, IIM patients had a 50% CRS rate & 0% ICANS rate, SSC patients had a 50% CRS & 50% ICANS rate, & MG patients had a 0% CRS & ICANS rate). Notably, the frequency & severity of CRS appears to be low, with no CRS in 63% of patients (12/19) & most CRS events (6/7) being Grade 1. The lower frequency & severity of both CRS & ICANS events are likely correlated with the relatively modest induction of serum IFNg, IL6, & IL8 found in autoimmune patients post rese-cel weight-adjusted dose infusion. High BAFF levels reflect deep systemic B cell depletion. Together, these data support further support late-stage clinical development of rese-cel in autoimmune disease.
Diagnosis · 2025-05-22
articleOpen accessOBJECTIVES: During the SARS-CoV-2 pandemic, new patient evaluations in pediatric rheumatology were performed using telehealth. Given the pediatric rheumatology workforce shortage, telehealth may be a way to efficiently triage referrals. The objective was to assess the utility of telehealth visits as a diagnostic tool to accurately assess the need for in-person evaluation. METHODS: This was a retrospective cohort study of patients evaluated by telehealth for a new patient visit from March 1 to June 30, 2020 at a tertiary center. Electronic health record documentation from subsequent rheumatology, specialty, and primary care encounters over the subsequent 4 years were reviewed. The primary outcome was diagnostic concordance, defined as consistency in the documented diagnostic reasoning, between the initial telehealth video visit and in-person follow-up visits. RESULTS: During the study period, there were 111 telehealth visits, 80 (72 %) of which had follow-up data. 55/80 had in-person rheumatology evaluations. Only 9 % patients had discordant diagnoses, all of whom had initial concern for inflammatory arthritis during the telehealth visit but a diagnosis of a non-inflammatory condition after in-person evaluation. Nine patients with a significant rheumatic disease were identified via telehealth. There were no unplanned ED visits or hospital admissions following telehealth visits. 33 % of patients were found to not warrant rheumatologic follow-up after the telehealth visit. CONCLUSIONS: For pediatric rheumatology new patient evaluations, diagnostic accuracy via telehealth evaluation was high. Providers triaged patients with chronic rheumatologic conditions for in-person evaluations and were able to accurately identify benign conditions that did not require in-person follow-up.
Evaluation of Health Disparities in Outcomes of Patients With Juvenile Idiopathic Arthritis
The Journal of Rheumatology · 2025-11-15
articleOBJECTIVE: Juvenile idiopathic arthritis (JIA) is complicated by morbidity, with suboptimal rates of prolonged remission, decreased health-related quality of life, and functional limitations. The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a North American learning health network, has a centralized registry of patients with JIA to track quality measures. We assessed for health disparities in our collaborative JIA population by evaluating our performance on disease activity outcomes, overall well-being, and pain by race and ethnicity, age, sex, and JIA subtype. METHODS: A cross-sectional analysis of patients in the PR-COIN registry was conducted to estimate the association between race and ethnicity groups and outcomes including physician global assessment of disease activity (PGA), patient/parent global assessment of overall well-being (PtGA), active joint count, 10-joint clinical Juvenile Arthritis Disease Activity Score (cJADAS10), arthritis-related pain intensity score, and morning stiffness duration. RESULTS: Data from 9601 patients were analyzed. Current age was positively and significantly associated with higher scores of pain intensity, PGA, PtGA, and cJADAS10. Non-Hispanic Black patients had statistically higher cJADAS10 scores compared to non-Hispanic White patients, in addition to statistically higher pain intensity scores, and PGA and PtGA scores. Female patients had statistically higher scores compared to male patients for all outcome variables assessed. CONCLUSION: We found disparities in outcomes of patients with JIA related to race and ethnicity, sex, and age. This information is imperative to drive further improvement efforts and understand possible causes of these differences to close disparity gaps and improve outcomes for all patients with JIA.
Annals of the Rheumatic Diseases · 2025-06-01 · 7 citations
articleGranulomatous hyperinflammatory state induced by dupilumab treatment for eosinophilic esophagitis
Journal of Allergy and Clinical Immunology Global · 2024-07-26 · 2 citations
articleOpen accessWe present the first case of a dupilumab-induced hyperinflammatory state in the setting of underlying eosinophilic esophagitis characterized by multisystem granulomatous inflammation. Although clinical trial data and subsequent real-world experience support dupilumab as a highly effective therapy for eosinophilic esophagitis, close monitoring for development of adverse symptoms following initiation remains paramount.
PEDIATRICS · 2024-05-01
articleOpen accessSenior author<h3>Background/Purpose</h3> Achievement of a lupus low disease activity state (LLDAS) has been associated with less organ damage, fewer disease flares, and improved health-related quality of life in children with systemic lupus erythematosus (cSLE). No prior studies have evaluated the implementation of lupus disease activity measure collection in the real-world. Our objective was to evaluate the acceptability, appropriateness, and feasibility of implementing a Treat to Target strategy for lupus in the pediatric rheumatology clinic. <h3>Methods</h3> The Pediatric Lupus Understanding Systems (PLUS) collaborative was formed consisting of 5 pediatric rheumatology sites located in children’s hospitals affiliated with academic medical centers in the United States. We operationalized the 5 cLLDAS criteria to collect at the point of care (table 1) with plans for implementation phase 1 to track collection of each criteria at cSLE visits on a monthly basis. We completed a baseline implementation assessment using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Each measure consists of 4 domains assessed on a Likert scale of 1–5 (1=completely disagree to 5=completely agree). Mean response was calculated for each domain. Barriers to cLLDAS criteria collection were also identified. <h3>Results</h3> We collected a baseline implementation assessment from each PLUS collaborative site leader (n=5). Sites reported a range of number of pediatric rheumatology providers (5–18), most had trainees in clinic, and 60% have mid-level providers (table 2). The approximate number of patients with cSLE seen in 2022 varied from 73–150 with a broad mix of insurance. All major electronic health record (EHR) vendors are represented. Implementing collection of cSLE disease activity measures and a Treat to Target strategy in the pediatric rheumatology clinic was largely found to be acceptable and appropriate (table 3). Scores for feasibility of the intervention were less positive. Themes of identified barriers to collection of cLLDAS criteria included: need for EHR adjustments to collect discrete data, availability of laboratory results to calculate disease activity during clinic visit, preexisting systems to collect physician global assessment on 0–10 scale, and physician burnout to change. <h3>Conclusion</h3> Implementation of a treat to target approach to care of patients with cSLE is acceptable and appropriate although will require a dedicated effort to be feasible. A key determinant to monitoring real-world performance is ability to customize EHR with discrete data fields. Next steps are to use implementation facilitation via monthly meetings to improve performance from baseline.
Arthritis Care & Research · 2024-09-23 · 1 citations
articleOpen accessOBJECTIVE: We linked pharmacy dispensing data to clinical data in the electronic health record (EHR) to (1) identify characteristics associated with adherence to methotrexate (MTX) and (2) determine the association between adherence and disease activity in patients with juvenile idiopathic arthritis (JIA). METHODS: We conducted a single-center retrospective cohort study of incident MTX recipients with JIA treated between January 2016 and September 2023 for ≥12 months. Using pharmacy dispensing data, complemented by EHR data, we estimated adherence using medication possession ratios (MPRs) over the first 365 days of treatment. We used Fisher's exact and Wilcoxon rank-sum tests to compare patient characteristics between adherent (MPR ≥80%) and nonadherent (MPR <80%) groups and multivariable linear regression to investigate associations between MPR and active joint count. RESULTS: Among 224 patients, 81 (36.2%) were classified as nonadherent. In bivariate analysis, patients of younger age, of Black race, and from areas with lower child opportunity index were more likely to be classified as nonadherent. In multivariable analysis, active joint count changed from baseline to 12-month follow-up by -0.38 joints in the adherent compared to nonadherent group (95% confidence interval [CI] -0.74 to -0.01) and by -1.18 joints in patients with polyarticular course (95% CI -2.23 to -0.13). CONCLUSION: Linking dispense data to clinical EHR data offers a novel, objective method for evaluating adherence to chronic medications. We identified demographic and area-level determinants of adherence, along with small but statistically significant differences in JIA disease activity measures by adherence status. Future work is needed to evaluate adherence as a potential mediator of known outcome disparities for socially disadvantaged populations.
Frontiers in Pediatrics · 2024-08-02 · 5 citations
articleOpen accessIntroduction: The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) is a North American learning health network focused on improving outcomes of children with juvenile idiopathic arthritis (JIA). JIA is a chronic autoimmune disease that can lead to morbidity related to persistent joint and ocular inflammation. PR-COIN has a shared patient registry that tracks twenty quality measures including ten outcome measures of which six are related to disease activity. The network's global aim, set in 2021, was to increase the percent of patients with oligoarticular or polyarticular JIA that had an inactive or low disease activity state from 76% to 80% by the end of 2023. Methods: Twenty-three hospitals participate in PR-COIN, with over 7,200 active patients with JIA. The disease activity outcome measures include active joint count, physician global assessment of disease activity, and measures related to validated composite disease activity scoring systems including inactive or low disease activity by the 10-joint clinical Juvenile Arthritis Disease Activity Score (cJADAS10), inactive or low disease activity by cJADAS10 at 6 months post-diagnosis, mean cJADAS10 score, and the American College of Rheumatology (ACR) provisional criteria for clinical inactive disease. Data is collated to measure network performance, which is displayed on run and control charts. Network-wide interventions have included pre-visit planning, shared decision making, self-management support, population health management, and utilizing a Treat to Target approach to care. Results: Five outcome measures related to disease activity have demonstrated significant improvement over time. The percent of patients with inactive or low disease activity by cJADAS10 surpassed our goal with current network performance at 81%. Clinical inactive disease by ACR provisional criteria improved from 46% to 60%. The mean cJADAS10 score decreased from 4.3 to 2.6, and the mean active joint count declined from 1.5 to 0.7. Mean physician global assessment of disease activity significantly improved from 1 to 0.6. Conclusions: PR-COIN has shown significant improvement in disease activity metrics for patients with JIA. The network will continue to work on both site-specific and collaborative efforts to improve outcomes for children with JIA with attention to health equity, severity adjustment, and data quality.
Clinical Immunology · 2024-04-09 · 15 citations
articleOpen accessOBJECTIVE: To derive childhood-onset SLE (cSLE) specific remission definitions for future treat-to-target (T2T) trials, observational studies, and clinical practice. METHODS: The cSLE International T2T Task Force conducted Delphi surveys exploring paediatric perspectives on adult-onset SLE remission targets. A modified nominal group technique was used to discuss, refine, and agree on the cSLE remission target criteria. RESULTS: The Task Force proposed two definitions of remission: 'cSLE clinical remission on steroids (cCR)' and 'cSLE clinical remission off steroids (cCR-0)'. The common criteria are: (1) Clinical-SLEDAI-2 K = 0; (2) PGA score < 0.5 (0-3 scale); (4) stable antimalarials, immunosuppressive, and biologic therapy (changes due to side-effects, adherence, weight, or when building up to target dose allowed). Criterion (3) in cCR is the prednisolone dose ≤0.1 mg/kg/day (maximum 5 mg/day), whereas in cCR-0 it is zero. CONCLUSIONS: cSLE definitions of remission have been proposed, maintaining sufficient alignment with the adult-SLE definition to facilitate life-course research.
Recent grants
NIH · $6.4M · 2006
NIH · $656k · 2012
Frequent coauthors
- 59 shared
Mary B. Leonard
Lucile Packard Children's Hospital
- 49 shared
Babette S. Zemel
University of Pennsylvania
- 36 shared
Justine Shults
Children's Hospital of Philadelphia
- 27 shared
Joyce C. Chang
Children's Hospital of Philadelphia
- 23 shared
Ronald M. Laxer
St. Michael's Hospital
- 21 shared
Edisio Semeao
- 20 shared
Pamela F. Weiss
Children's Hospital of Philadelphia
- 18 shared
Laura B. Lewandowski
National Institutes of Health
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