
Pamela Weiss
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1953–2026
About
Pamela Weiss, M.D., M.S.C.E., is a Professor of Pediatrics (Rheumatology) at the Children's Hospital of Philadelphia and a Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania. Her research focuses on pharmacoepidemiology and outcomes research in pediatric juvenile idiopathic arthritis (JIA) and juvenile spondyloarthritis. She has advanced training in clinical epidemiology and biostatistics through the University of Pennsylvania School of Medicine Center for Clinical Epidemiology and Biostatistics master’s degree program. Her research aims include improving the diagnosis of pediatric spondyloarthritis, which encompasses enthesitis-related arthritis and psoriatic arthritis, better defining disease activity in children with spondyloarthritis, and developing treatment strategies that enhance both clinical and patient-reported outcomes.
Research topics
- Computer Science
- Nanotechnology
- Materials science
- Engineering
Selected publications
Arthritis Care & Research · 2026-04-20
articleOpen accessSenior authorOBJECTIVE: The concern that nonsteroidal anti-inflammatory drugs (NSAIDs) may precipitate flares of inflammatory bowel disease (IBD) has limited their use in managing musculoskeletal symptoms in those with IBD, but safety data are mixed. METHODS: This retrospective cohort study included patients with IBD aged at least 18 years from Optum's deidentified Clinformatics Data Mart Database (2000-2022). Patients with a new NSAID prescription fill were matched to those without an NSAID fill during the study period. The index date for exposed patients was the date of first NSAID fill, with a matched date for unexposed. Propensity score-based inverse probability of treatment-weighted Cox proportional hazards models evaluated the association between NSAID exposure and time to IBD-related hospitalization across IBD subtypes. A hazard ratio (HR) of 1.2 was prespecified as the non-inferiority margin. RESULTS: Among 348,095 patients with IBD, 23.2% were NSAID-exposed. NSAID exposure was associated with a small increase in IBD-related hospitalization in the overall cohort but demonstrated non-inferiority (HR 1.07, 95% confidence interval [CI] 1.04-1.10). Non-inferiority was met with no significantly increased risk of IBD-related hospitalization in patients with ulcerative colitis (HR 0.97, 95% CI 0.93-1.02). In contrast, non-inferiority was not met in the Crohn disease subgroup (HR 1.16, 95% CI 1.12-1.21). CONCLUSION: Patients with ulcerative colitis did not have a significantly increased risk of IBD-related hospitalization associated with NSAID exposure and met non-inferiority, whereas non-inferiority could not be established for those with Crohn disease. These results suggest that NSAID use may be acceptable for select patients with IBD who have significant musculoskeletal symptoms, especially those with ulcerative colitis.
Examining Hope in Adolescents with Chronic Musculoskeletal Pain
Children · 2026-03-27
articleOpen accessBackground/Objectives: This cross-sectional study aimed to quantify hope levels in adolescents with chronic musculoskeletal pain (CMP) and examine patient-reported outcomes associated with hope. Methods: This was an exploratory, cross-sectional, secondary analysis of baseline data from a prospective, single-center longitudinal study of 60 youth presenting for an initial evaluation at a pediatric subspecialty pain clinic. Subjects were English-speaking 12–17-year-olds with a diagnosis of CMP, primarily female and non-Hispanic White, with diffuse pain, median pain duration of 2 years, and moderate to severe physical dysfunction. Subjects completed surveys measuring hope (Children’s Hope Scale [CHS]) and patient-reported mental, physical, and overall health. Associations between hope scores (total and each subscale) and patient-reported outcomes were evaluated using Spearman rank correlations. Results: The median CHS score was 20.0 (IQR: 16.5–25.0), indicating slight hope. Patient hope was negatively correlated with depression (r = −0.61), anxiety (r = −0.49), psychological distress (r = −0.52), functional disability (r = −0.43), and pain interference (r = −0.37), but not pain intensity. Adolescents’ hope was positively correlated with resilience (r = 0.74) and overall health (r = 0.55; all p < 0.01). Conclusions: Hope is correlated with various patient-reported health measures in youth with CMP. Although causal inferences are not possible due to the cross-sectional nature of this study, the results suggest that hope may be an important coping mechanism in pediatric chronic pain. Future efforts to incorporate existing resilience coaching programs into usual care may improve hope and health-related quality of life in youth with CMP.
Gastroenterology · 2026-01-22
articleSenior authorInflammatory Bowel Diseases · 2026-01-22
articleSenior authorAbstract BACKGROUND The concern that nonsteroidal anti-inflammatory drugs (NSAIDs) may precipitate flares of inflammatory bowel disease (IBD) has limited their use in managing musculoskeletal symptoms in this population, but safety data are mixed. METHODS This was a retrospective cohort study of IBD patients from Optum’s de-identified Clinformatics Data Mart Database (2000-2022). Patients with a new NSAID prescription fill (“exposed”) were matched to those without an NSAID fill during the study period (“unexposed”) by age and calendar year when IBD criteria were met (Figure 1). The index date for exposed patients was date of first NSAID fill; unexposed patients were assigned a matched index date based on time from meeting IBD criteria. A propensity score was calculated to balance covariates across exposure groups. The primary outcome was IBD-related hospitalization, defined as any hospitalization &gt;1 day duration with an IBD diagnosis code as the primary or secondary discharge code. Secondary outcomes included all-cause hospitalization and gastrointestinal surgery. Propensity score-based inverse probability of treatment weighted (IPTW) Cox proportional hazards models evaluated the association between NSAID exposure and time to each outcome across IBD subtypes. A hazard ratio (HR) of 1.2 was set as the pre-specified non-inferiority margin based on discussions with IBD content experts. RESULTS Among 271,236 patients with IBD, 29.7% were NSAID exposed. All covariates were balanced across groups after IPTW. In the IPTW-weighted Cox model, NSAID exposure was associated with a small increase in IBD-related hospitalization in the overall IBD cohort (HR 1.08, 95% CI 1.05-1.11; Figure 2) but demonstrated non-inferiority. Exposed patients experienced an adjusted 0.06 IBD-related hospitalizations/person-year versus 0.05 events/person-year in the unexposed group (absolute risk difference 0.007, number needed to harm 137). No significant increase in IBD-related hospitalization was seen in the ulcerative colitis subgroup (HR 0.96, 95% CI 0.91-1.01), but there was a significant increase in those with Crohn’s disease (HR 1.16, 95% CI 1.11-1.21), with non-inferiority not met. There were significantly higher rates of gastrointestinal surgery (overall HR 1.23, 95% CI 1.19-1.28) and all-cause hospitalization (overall HR 1.30, 95% CI 1.28-1.32) with neither meeting non-inferiority. CONCLUSION Prescription NSAID exposure was associated with a numerically small risk of IBD-related hospitalization below the pre-specified non-inferiority threshold. Risk was not seen in patients with ulcerative colitis, while small magnitude risks were present in those with Crohn’s disease. These results challenge the current paradigm of avoiding NSAIDs in all patients with IBD and suggest that NSAID risks may be acceptable for many patients with significant joint disease.
Arthritis Care & Research · 2025-09-18 · 1 citations
articleOpen accessSenior authorOBJECTIVE: Recent inflammatory bowel disease (IBD) treatment guidelines have recommended against nonsteroidal anti-inflammatory drug (NSAID) use despite prevalent musculoskeletal symptoms and opioid overuse in this population. Given the discordance between changing national guidelines and potential clinical utility, we sought to assess national temporal trends in prescription NSAID and opioid use for patients with IBD and factors associated with NSAID fill trends. METHODS: This retrospective cohort study of adult and pediatric IBD patients used administrative claims data from 2000 to 2022. Prescription NSAID and opioid fills per calendar year were assessed. Wilcoxon-Cuzick test of trend and generalized estimating equation models evaluated NSAID and opioid fill trends and assessed characteristics associated with NSAID use. RESULTS: Among the 361,025 IBD patients, there was a significant decreasing trend in the proportion prescribed NSAIDs over time (P < 0.01). Fill rates of NSAIDs were markedly lower than opioids across the study period despite an increase in musculoskeletal pain codes. In the multivariable model, opioid prescription (odds ratio [OR] 2.13, 95% confidence interval [CI] 2.11-2.15), a diagnostic code for osteoarthritis (OR 1.57, 95% CI 1.55-1.59), or unspecified joint pain (OR 1.54, 95% CI 1.52-1.56) had strong independent associations with NSAID fill, whereas an age <18 or ≥80 years were associated with significantly lower odds of NSAID fill. CONCLUSION: NSAIDs are used by a minority of patients with IBD, with decreasing prescription rates over time despite high rates of opioid use and a doubling of musculoskeletal complaints. NSAID safety needs more thorough examination as an effective and potentially lower-risk analgesic option for patients of all ages with IBD.
Annals of the Rheumatic Diseases · 2025-06-01
articleOpen access<h2>Abstract</h2><h3>Background:</h3> Tofacitinib has been shown to be efficacious in the treatment of polyarticular course JIA, including systemic JIA (sJIA) without active systemic features. The previous Phase 3 trial of tofacitinib in JIA enrolled patients with sJIA without active systemic features, but not patients with active sJIA [1]. <h3>Objectives:</h3> To investigate the efficacy, safety and tolerability of tofacitinib in participants with sJIA with active disease. <h3>Methods:</h3> This was a Phase 3, global, 2-phase, randomised withdrawal study (NCT03000439), enrolling participants aged 2–<18 years with active sJIA. In the open-label phase, participants were treated with tofacitinib (5 mg twice daily or equivalent weight-based dose): in Part 1 (up to 16 weeks), participants had to achieve and maintain an adapted (a) JIA-ACR30 response for ≥4 weeks to proceed to open-label Part 2 (up to 24 weeks), in which participants treated with corticosteroids ˃0.2 mg/kg/day attempted to taper while maintaining clinical response. Responders (aJIA-ACR30, tapered corticosteroids) were eligible to enter the double-blind phase and were randomised to either continue tofacitinib or switch to placebo. The primary endpoint was time to sJIA disease flare in the double-blind phase. Secondary efficacy endpoints and safety were assessed during the open-label and double-blind phases. A prespecified interim analysis was performed after 28 participants reported an sJIA flare in the double-blind phase. <h3>Results:</h3> Overall, 100 participants were enrolled in the open-label phase from members of the PRINTO/PRCSG networks; 59 were randomised into the double-blind phase (28 tofacitinib, 31 placebo). At study entry, 75/100 (75.0%) participants had active systemic features, based on the presence of fever or rash within the week prior to enrolment. The prespecified futility stopping criterion was met and the study did not meet the primary objective of demonstrating statistically significant prolongation in time to sJIA disease flare in the double-blind phase (HR 0.633; 95% CI 0.296, 1.354; 1-sided p=0.1171) for tofacitinib vs placebo (Figure 1). However, fewer participants experienced flares with tofacitinib (11/28; 39.3%) vs placebo (17/31; 54.8%; Figure 1b). Median time to flare was 295 days with placebo and could not be calculated for tofacitinib as <50% of participants had a flare (Figure 1c). During open-label Part 1, aJIA-ACR30/70/90 responses were reached by 71/82 (86.6%), 28/82 (34.1%) and 15/82 (18.3%) of participants at Week 8 (Figure 2a-c). Clinically meaningful improvements in CHAQ-DI were noted during open-label Part 1, with median changes from baseline exceeding the minimal clinically important improvement of -0.188 from Week 2 (-0.25) through to Week 16 (-0.63). Similarly, median changes from baseline in JADAS-27 CRP exceeded the clinically important improvement of -5.5 at Week 2 (-7.87) through to Week 16 (-13.87). Responses were generally maintained during open-label Part 2 despite corticosteroid taper; 38/54 (70.4%) participants achieved tapering criteria. Imbalances in disease activity were observed at double-blind randomisation, including greater proportions of participants with aJIA-ACR90 responses and JADAS-27 CRP inactive disease randomised to placebo compared with tofacitinib (Figure 2c-d). The tofacitinib group generally maintained the efficacy response for these outcomes during the double-blind phase. In the double-blind phase, frequencies of treatment emergent (TE) adverse events (AEs) were comparable between groups; no participants in the tofacitinib group had severe/serious AEs. A higher percentage of participants had TEAEs leading to discontinuation in the placebo group vs the tofacitinib group, driven by a greater number of sJIA flare TEAEs for placebo (14/31; 45.2%) vs tofacitinib (8/28; 28.6%). <h3>Conclusion:</h3> Improvements in sJIA disease activity were observed with open-label tofacitinib treatment after 7 days, with >80% of participants achieving an aJIA-ACR30 response by 8 weeks. However, the primary efficacy objective in the double-blind withdrawal phase was not met. Important imbalances at randomisation may have influenced the results and been driven by the overall small sample size. Safety findings were consistent with the known profile of tofacitinib in adults and children. <h3>REFERENCES:</h3> [1] Ruperto et al. Lancet 2021; 398: 1984-96. <h3>Acknowledgements:</h3> Study sponsored by Pfizer. The sponsor was involved in the design and management of the trial and data analysis. Data were collected by the investigators. Independent evaluation of primary and key secondary outcomes was performed by the PRINTO and PRCSG coordinating centres in Genova, Italy and Cincinnati, OH, USA, respectively. Medical writing support, under the direction of the authors, was provided by Julia King, PhD, CMC Connect, a division of IPG Health Medical Communications, and was funded by Pfizer, New York, NY, USA, in accordance with Good Publication Practice (GPP 2022) guidelines (Ann Intern Med 2022; 175: 1298-1304). <h3>Disclosure of Interests:</h3> Nicolino Ruperto Consultant for AbbVie, Aclaris, AlfaSigma, Amgen, AstraZeneca, Aurinia, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Guidepoint, Idorsia, Janssen, Novartis, Pfizer Inc, Roche Genentech, and Takeda, Caifeng Li: None declared, Kogielambal Chinniah: None declared, Yosef Uziel: None declared, Olga Synoverska: None declared, Sujata Sawhney: None declared, Inmaculada Calvo Speakers bureau for AbbVie, GSK, Novartis, Pfizer Inc, and Sobi, Consultant for GSK, Grant/research support from AbbVie, Lilly, Novartis, Pfizer Inc, and Sanofi, Ingrid Louw Grant/research support from Bristol Myers Squibb, Idorsia, Novartis, Pfizer Inc, Roche, and Sanofi, meiping Lu: None declared, Pooja Nikunj Patel Shareholder in CVS/Oak Street Health, Grant/research support from AbbVie, AstraZeneca, and Pfizer Inc, Pamela F. Weiss Speaker's bureau for RheumNow and Spondyloarthritis Research and Treatment Network, Consultant for Biogen, Cerecor, Lilly, Novartis and Pfizer Inc, Grant/research support from AbbVie, NIH, Patient-Centered Outcomes Research Institute, Pfizer Inc, and Spondylitis Association of America, Cheng Chang Shareholder of Pfizer Inc, Employee of Pfizer Inc, Ivana Vranic Employee of Pfizer Ltd, Shixue Liu Employee of Pfizer Inc, Annette Diehl Shareholder of Pfizer Inc, Employee of Pfizer Inc, Jose L. Rivas Shareholder of Pfizer Inc, Employee of Pfizer SLU, Carol A. Connell Employee of Pfizer Inc at the time of the study, Gary G Koch Grants/research support from AbbVie, Acadia Pharmaceuticals, Aerovant Therapeutics, Amgen, AstraZeneca, Bayer, Cytokinetics, Ensho Therapeutics, Galderma Research Development, Gilead, GSK, HUYA Bioscience International, Intra-Cellular Therapies, Ironwood Pharmaceuticals, Johnson & Johnson, Momentum, Novan, Otsuka, Pfizer Inc, Priovant Therapeutics, Prometheus Biosciences, Regeneron Pharmaceuticals, Scholar Rock, Summit Therapeutics, Televant Inc, UCB, vTv Therapeutics, and XyloCor Therapeutics, Alberto Martini Consultant for Janssen and Pfizer Inc, Daniel J Lovell Consultant for AstraZeneca, GSK, Novartis, Pfizer Inc, and UCB, Grant/research support from Bristol Myers Squibb, Janssen, and Roche, Hermine Brunner Consultant for AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer Inc, and UCB, Grants/research support from Genentech and Pfizer Inc. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.
Current Rheumatology Reports · 2025-11-18
articleOpen accessSenior authorCorrespondingPURPOSE OF REVIEW: Until recently, the absence of validated, pediatric-specific classification criteria for juvenile spondyloarthritis (JSpA) limited targeted clinical trials evaluating treatment efficacy and advancements in understanding the natural history in pediatric-onset disease. There is an urgent need for efficacy and effectiveness studies in this understudied group. RECENT FINDINGS: Most children with JSpA continue to experience disease activity despite current therapies and generally have worse outcomes than those with other juvenile arthritis forms. Fewer than 20% achieve remission within five years of diagnosis. Axial involvement is a distinct manifestation warranting separate study and management, as it does not respond to conventional agents like methotrexate used for peripheral arthritis. Comparative effectiveness data are lacking, and no medications are FDA-approved specifically for "juvenile spondyloarthritis" or "juvenile ankylosing spondylitis." The only FDA-approved therapy for enthesitis-related arthritis (ERA) is secukinumab. In 2024, pediatric classification criteria for axial disease in JSpA were published. These criteria include seven domains: MRI inflammation, MRI structural lesions, pain chronicity, pain pattern, pain location, stiffness, and genetic association. Imaging evidence of axial disease is necessary but not sufficient for classification. This review provides an overview of JSpA epidemiology, current and emerging classification criteria, and highlights the key features of the newly validated pediatric axial JSpA classification criteria.
The Challenges of New Biologic Therapies in Pediatrics
Rheumatic Disease Clinics of North America · 2025-06-09
reviewOpen accessSenior authorArthritis Care & Research · 2025-05-02 · 2 citations
articleOpen accessSenior authorCorrespondingOBJECTIVE: The objective of this study was to determine a core set of measures for youth with juvenile spondyloarthritis and axial disease (axJSpA), using the juvenile arthritis working group Outcome Measures in Rheumatology framework. METHODS: This was a prospective multicenter study of youth with axJSpA. Participants (aged 8-18 years) all initiated tumor necrosis factor inhibitor (TNFi) therapy and completed questionnaires, examinations, and magnetic resonance imaging (MRI) at baseline and 12 weeks. Responsiveness and discrimination were assessed using standardized response mean (SRM) and standardized mean difference (SMD). For highly correlated (r > |0.80|) items within domains, larger SRM and SMD were prioritized, and minimal clinically important improvement was determined for each. RESULTS: Of the evaluable cohort (N = 57), 68.4% were male, and the median age was 15.3 years; 70.2% of youth treated with TNFi had clinical response (change ≥2 in patient global assessment). Although 58% had continued MRI inflammation, 77% of those patients reported moderate clinical improvement. The final axJSpA core set contained the following: Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (SRM 0.77, SMD 0.5), the sacroiliac joint inflammation score (SRM 1.02, SMD 0.52), PROMIS mobility (SRM 0.83, SMD 0.75), and patient global well-being (SRM 0.88, SMD not applicable). All overall and composite disease activity measures tested, except the physician global assessment, had high SRM and SMD. Subgroup analysis demonstrated differences by biologic sex and overweight status. Improvement in the MRI inflammation score was greater in male patients. Improvement in the PROMIS pain interference and mobility measures was greater in those with normal body mass index. CONCLUSION: A set of measures was developed for youth with axJSpA.
JMIR Research Protocols · 2025-07-22
articleOpen accessBACKGROUND: Levels of self-perceived psychological resilience are low to moderate among youth with chronic musculoskeletal pain (CMP). Furthermore, resilience has been associated with symptom severity in CMP. Resilience coaching programs may therefore be of benefit in the nonpharmacologic management of adolescent CMP and may serve as an adjunctive way to access mental health services in an approachable and affordable way. OBJECTIVE: The main goal of the study is to assess the feasibility, acceptability, and preliminary efficacy of the resilience coaching program called Promoting Resilience in Stress Management (PRISM) and to obtain the data needed to plan a larger trial. METHODS: The Resilience Coaching for Adolescents with Chronic Musculoskeletal Pain pilot study is an investigator initiated, 2-arm, randomized controlled trial (RCT) of PRISM in the interdisciplinary management of CMP among adolescents. The study will compare usual care versus PRISM+usual care among adolescents newly diagnosed with CMP in the outpatient setting. One caregiver per patient will also be enrolled. The control group will receive usual care with no specific intervention. The treatment arm will receive PRISM, which is a remotely delivered, 1-on-1resilience coaching program, consisting of 4 required skill-based sessions and an optional final session. Sessions will be delivered every 1-2 weeks, lasting about 3 months in total. The primary outcome is the Functional Disability Inventory (FDI) score at 3 months postrandomization. The secondary objectives are to evaluate potential patient- and caregiver-level moderators of PRISM and identify facilitators of and barriers to engagement in PRISM. The estimated sample size is 65 patient-caregiver dyads per group, for a total of 130 dyads. RESULTS: The trial is currently open. Initial Institutional Review Board approval was obtained on April 4, 2023, and protocol version 4 was amended on January 14, 2025. Recruitment began on May 8, 2023, and recruitment is anticipated to be completed on August 1, 2025. CONCLUSIONS: Resilience coaching has demonstrated excellent feasibility, acceptability, and efficacy in teenagers with chronic illness; however, evidence to support its use in adolescent CMP is lacking. Resilience coaching has the potential to improve patient outcomes in this population. This pilot RCT will demonstrate acceptability, feasibility, and preliminary efficacy and reveal critical barriers to and facilitators of engagement. This will inform a larger multisite trial to evaluate the definitive efficacy of the intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05834725; https://clinicaltrials.gov/study/NCT05834725. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/73385.
Recent grants
NIH · $678k · 2019–2024
NIH · $220k · 2016
NIH · $88k · 2008
Mentoring and Patient Oriented Research in Juvenile Spondyloarthritis
NIH · $531k · 2022–2027
NIH · $610k · 2017
Frequent coauthors
- 153 shared
Rui Xiao
Nanchang University
- 121 shared
Timothy G. Brandon
Children's Hospital of Philadelphia
- 113 shared
R. Lambert
University of Alberta
- 112 shared
Joyce C. Chang
Children's Hospital of Philadelphia
- 109 shared
Walter P. Maksymowych
- 102 shared
Nancy A. Chauvin
Cleveland Clinic
- 99 shared
David M. Biko
Children's Hospital of Philadelphia
- 92 shared
Jacob L. Jaremko
University of Alberta
Labs
Pamela Weiss LaboratoryPI
Education
- 2009
M.S.C.E., Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania
- 2002
M.D.
Yeshiva University Albert Einstein College of Medicine
- 1998
A.B.
Princeton University
Awards & honors
- Senior Scholar, Center for Clinical Epidemiology and Biostat…
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