“I’ve always been fascinated by the immune system, and I enjoy trying to figure out puzzling patients,” explains pediatric rheumatologist Dr. Tim Beukelman, from his office at The Children’s Hospital of Alabama.
That explains the monumental task he undertook recently when, with a team of pharmacoepidemiologists at UAB, he waded through billions of Medicaid billing records in an attempt to discover whether a class of drugs that improves the lives of many children suffering from juvenile arthritis, also causes cancer.
The drugs, called TNF-inhibitors, are highly effective for many children in reducing inflammation. But in the fall of 2009, the FDA tagged the drugs with a black box warning after receiving reports that children who were taking them developed malignancies, especially lymphomas. However, no adequate research had been done to look at cancer rates in children with juvenile arthritis who were not on the drugs.
Beukelman and his team found that, according to records they examined, having juvenile arthritis alone increased the child’s risk for cancer, compared with healthy children (a result published in the April issue of the journal Arthritis & Rheumatism).
Beukelman’s team determined that treatment with TNF-inhibitors did not appear to increase the risk of cancer in children with juvenile arthritis—a sure relief for parents of patients who are on the life-altering drugs.
“Kids diagnosed with arthritis have higher rates of cancer than those without arthritis, and no one had demonstrated this before,” he says.
Now Beukelman is boosting his study’s numbers by looking at four more years of Medicaid billing records.
Beukelman came to UAB in 2007 after completing a fellowship in pediatric rheumatology and earning a degree in clinical epidemiology at the University of Pennsylvania. As is the case with many junior research investigators, he was uncertain whether he would receive the National Institutes of Health Career Development or “K award” funding from the federal government, to which he had applied. So Beukelman simultaneously applied for one of two CCTS-sponsored K awards—and got it.
“The award has provided me with several years of salary support, which enables me to undertake these research projects, rather than spending all of my time grant writing,” he says. The funding made possible his role in the TNF-inhibitor research, and also allowed for him to be the lead investigator for developing the first-ever treatment guidelines for juvenile arthritis.
“Juvenile arthritis is the most common thing we treat as pediatric rheumatologists, and is also the most amenable to epidemiologic research,” Beukelman says. “It can occur at any age and is a usually a life-long condition where the immune system is attacking the joints.”
Dr. Kenneth Saag, (MD, MSc, Professor, Division of Clinical Immunology and Rheumatology) says he has enjoyed serving as Beukelman’s mentor as a CCTS-sponsored KL2 award recipient.
“Tim is very gifted physician scientist who is filling a unique niche in the field of pediatric rheumatology. He has developed expertise in working with large databases,” Saag says. “Through the CCTS-funded KL2 award, Tim has been able to do some pivotal work on the larger pharmacoepidemiology program at UAB. As an early-stage assistant professor, he led a national initiative to develop guidelines for pediatric rheumatology. He has developed unique skills that he has refined through collaborations with co-mentors in a very effective way.”
In addition to the CCTS-sponsored funding allowing him to focus on his research, Beukelman has found support through CCTS career development programs, which offer help in finding mentors and securing promotions.
Beukelman says he “would encourage all investigators to explore internal funding opportunities.”
One example of funding provided by the CCTS is its Pilot Program—a partnership between the CCTS and the Council of Center Directors (COCD). The Pilot Program operates with a goal of developing investigator-initiated pilot projects, with a focus on creating new interdisciplinary clinical and translational research projects at UAB. These yearlong grants often fund junior investigators and act as a catalyst to initiate research projects.
The CCTS also supports its K-award Scholars via the K-Club, led by Dr. Saag. The K-Club tries to address the needs of career development awardees across the UAB campus. Open to all UAB individual and institutional career development awardees, its events serve to provide helpful information on publications, funding, and career planning