Tuesday, December 16, 2025 12/16/2025

Understanding disease modifying antirheumatic drug use in older adults with late-onset rheumatoid arthritis

Award Number: K23AG082727
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/20/2023
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Understanding disease modifying antirheumatic drug use in older adults with late-onset rheumatoid arthritis - PROJECT SUMMARY/ABSTRACT Rheumatoid arthritis (RA) is a chronic, debilitating inflammatory disease that affects 1.3 million older adults in the US. The number of older adults living with RA is growing and one-third are diagnosed with late-onset RA (LORA), characterized by more severe disease, greater comorbidity burden at time of diagnosis, and disability. Older adults with RA are less likely to receive effective disease modifying antirheumatic drugs (DMARDs) and more likely to receive long-term glucocorticoids alone for treatment which suggest we may be accepting less than optimal management in this population and better outcomes may be achievable. Dr. Jiha Lee is an Assistant Professor at the University of Michigan whose long-term goal is to become an independent investigator and national leader in geriatric rheumatology focused on advancing the science of effective medication use to improve the care of older adults with rheumatic diseases. This K23 Mentored Patient- Oriented Research Career Development Award application (PA-20-205) will support Dr. Lee to gain additional training and mentoring, and by completing the proposed work to become one of the few clinician-scientists with unique qualifications at the intersection of rheumatology, aging, pharmacoepidemiology, and mixed methods research to conduct rigorous aging research in the field of rheumatology. The overarching scientific goal of this mentored-research proposal is to investigate suboptimal DMARD use and tolerability to different treatment regimens in usual care among older adults with LORA and to engage patients and providers to better understand observed outcomes. The proposed explanatory sequential mixed methods study will use nationally representative Medicare claims data for Aims 1 and 2, followed by in-depth semi-structured interviews with patients and providers for Aim 3. Specifically, in Aim 1, Dr. Lee will examine patient and provider/healthcare factors associated with suboptimal DMARD use in older adults with LORA during the first 12 months after index date of diagnosis, gathering critical information to identify targets for future efforts to improve DMARD use. To build toward more evidence-based prescribing, in Aim 2 she will examine outcomes associated with different treatment regimens and identify patients at greatest risk of poor outcomes. In Aim 3, she will use the results from Aims 1 and 2 to guide the sampling strategy and discussion guide development to engage patients with LORA and providers to examine and inform additional potentially important factors that drive treatment approaches. Dr. Lee will conduct all work at the rich environment of the University of Michigan, with guidance from her exceptional team of mentors and advisors led by Dr. Julie Bynum. The proposed work will lay the foundation to identify subpopulations at risk of poor outcomes and build the evidence base for an R01-level application to inform development and evaluation of age-appropriate approaches to treatment of LORA.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	3	12/2/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $194,400 )
2025	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	3	9/8/2025	NON-COMPETING CONTINUATION	$194,400
														Subtotal = $194,400

Issue Date FY: 2024 ( Subtotal = $194,400 )
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	2	7/10/2024	NON-COMPETING CONTINUATION	$194,400
														Subtotal = $194,400

Issue Date FY: 2023 ( Subtotal = $194,400 )
2023	2023	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	1	9/20/2023	NEW	$194,400
														Subtotal = $194,400

Grand Total All Awards = $583,200

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Understanding disease modifying antirheumatic drug use in older adults with late-onset rheumatoid arthritis

Award Number: K23AG082727

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/20/2023

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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