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Melissa A. Lerman, MD, PhD, MSCE
Attending Physician
Dr. Lerman's research interests include non-infectious uveitis and temporomandibular (TMJ) arthritis. Her studies examine the utility of biologic agents to achieve, and maintain, uveitis control. Up to 80 percent of children with juvenile idiopathic arthritis (JIA) have potentially erosive TMJ arthritis, and she is exploring ways to best identify and monitor this often asymptomatic manifestation of JIA.
Bio
Uveitis, inflammation of the eye, commonly occurs in rheumatologic diseases and may affect ~20% of children with JIA. Uveitis can be vision threatening, even resulting in blindness. Although treated with a combination of topical and systemic immunomodulatory therapies there is limited understanding of the impact of the systemic medications on the natural history of uveitis.
Dr. Lerman studies the outcomes of children treated with biologic agents (e.g. cytokine blockade) for uveitis. She has described how quickly uveitis is controlled under anti-tumor necrosis factor alpha therapies (anti-TNFa), and how long disease remains quiet once anti-TNFa is discontinued. Along with colleagues from the Childhood Arthritis and Rheumatology Research Alliance (CARRA), she is studying the effectiveness of newer biologic agents to treat uveitis nonresponsive to anti-TNFa. She participated in the development of CARRA consensus treatment guidelines for uveitis. Along with an ophthalmology colleague, Dr. Lerman co-founded and co-directs one of the few combined rheumatology-ophthalmology uveitis clinics in the nation, the Uveitis Coordinated Care Clinic.
Up to 75 percent of children with JIA develop arthritis of the jaw (TMJ). It can result growth abnormalities (overbite, small jaw, jaw asymmetry), functional limitations and orofacial pain. Together with specialists from oral and maxillofacial surgery, Dr. Lerman is examining the long-term effects of TMJ arthritis on facial deformity and dysfunction in adults with JIA. As TMJ arthritis is most often painless, it is challenging to diagnose. As co-leader of the CARRA TMJ workgroup, she works to find better ways to identify and monitor jaw involvement in JIA.
In the long term, Dr. Lerman plans to use the results from these studies to inform the development of standardized screening and treatment guidelines for children with JIA.
Education and Training
BA, Yale University (Biology), 1996
PhD, University of Pennsylvania (Immunology), 2003
MD, University of Pennsylvania, 2005
Fellowship, Children's Hospital of Philadelphia (Rheumatology), 2011
MSCE, University of Pennsylvania (Clinical Epidemiology), 2012
Titles and Academic Titles
Attending Physician
Associate Fellowship Director, Pediatric Rheumatology
Assistant Professor of Clinical Pediatrics
Professional Memberships
American Academy of Pediatrics, 2005-2008
American College of Rheumatology, 2009
Childhood Arthritis and Rheumatology Research Alliance, 2010
Professional Awards
Goldie Simon Summer Preceptorship Award, Lupus Foundation of SE PA, 2001
Keystone Symposia Scholarship Winner, 2002
ACR REF Rheumatology Fellowship Training Award, 2008-2009
Publication Highlights
PubMed:
Stoustrup P, Resnick CM, Pedersen TK, Abramowicz S, Michelotti A, Küseler A, Verna C, Kellenberger CJ, Berit Nordal E, Caserta G, Jankovska I, Halbig JM, Kristensen KD, Arvidsson LZ, Spiegel L, Stoll ML, Lerman M, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomäki T, Herlin T, Peacock ZS, Twilt M; TMJ Juvenile Arthritis Working Group. Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis: International, Multidisciplinary Consensus-based Recommendations. J Rheumatol. 2019 Jan; pii: jrheum.180785. PMID: 30647179
Angeles-Han ST, Lo MS, Henderson LA, Lerman MA, Abramson L, Cooper AM, Parsa MF, Zemel LS, Ronis T, Beukelman T, Cox E, Sen HN, Holland GN, Brunner HI, Lasky A, Rabinovich CE; Juvenile Idiopathic Arthritis Disease-Specific Uveitis Subcommittee of Childhood Arthritis Rheumatology Research Alliance. Childhood Arthritis and Rheumatology Research Alliance consensus treatment plans for juvenile idiopathic arthritis-associated and idiopathic chronic anterior uveitis. Arthritis Care Res. 2018 May; PMID: 29806733
Lerman, MA, Rabinovich, CE. The Future is Now – Biologics for Non-Infectious Pediatric Anterior Uveitis. Paediatr Drugs. 2015 Aug; 17(4):283-301. PMID: 25893479
Lerman, MA, Lewen, MD, Kempen, JH, Mills MD.. Uveitis Reactivation in Children Treated with Tumor Necrosis Factor-α Inhibitors. Am J Ophthalmol. 2015 Jul; 160(1):193-200.e1. PMID: 25892124
Lerman MA, Burnham JM, Chang PY, Daniel E, Foster CS, Hennessy S, Jabs DA, Joffe MM, Kaçmaz RO, Levy-Clarke GA, Mills MD, Nussenblatt RB, Rosenbaum JT, Suhler EB, Thorne JE, Kempen JH. Response of pediatric uveitis to tumor necrosis factor-α inhibitors. Rheumatol. 2013 Aug; 40(8):1394-403. PMID: 23818712