Tuesday, July 1, 2025 7/1/2025

Improving shared decision-making around the use of disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis and cancer

Award Number: K23AR079588
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/01/2022
PERIOD OF PERFORMANCE END DATE: 06/30/2027

Group Awards By:

View Award Description

Improving shared decision-making around the use of disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis and cancer - PROJECT SUMMARY Over 1.8 million Americans have rheumatoid arthritis (RA). Compared to the general population these patients are at an increased risk of developing cancer, especially lymphoma and lung cancer. There has been a theoretical concern that use of immunosuppressive agents may impair immune responses to tumors placing patients at risk for developing new cancers and for recurrence of previously treated cancers. These concerns have made clinicians reluctant to use standard therapies for RA in patients with an active or recently diagnosed cancer. Although only a limited number of studies have evaluated their safety, they have in fact not shown any signal of harm from disease modifying anti-rheumatic drugs (DMARDs) in patients with RA and cancer. However, these studies have numerous limitations including focus on mostly patients with remote (> 5 years) history of cancer, small sample sizes, focus on only certain DMARDs, and/or limited information on cancer- specific mortality and other outcomes that might matter to patients. Also, nothing is known about the perspectives and experiences of patients with RA who are being treated for a cancer and how this experience might shape their willingness to use DMARDs. Treatment guidelines for the management of RA support a shared decision-making (SDM) approach that attempts to leverage the professional expertise of the rheumatologist to uphold what is most important to each patient. We herein propose a mixed methods approach to identify the optimal ways to enhance delivery of care for these patients and to provide a foundation for shared decision making to ensure alignment between treatment decisions and the values, goals, and preferences of individual patients. The studies proposed here will build an evidence base to identify the safest DMARD options for patients with RA who develop cancer (Aim 1); elicit the experiences, perceptions, and most valued outcomes of patients with RA and an active or recently diagnosed (<5 years) cancer, their family members and clinicians who care for these patients (Aim 2). The overall goal of this K23 mentored career development proposal is to support Dr. Namrata Singh’s development as an independent, patient-oriented researcher whose long-term goal is to develop a research agenda focused on the identification of factors that contribute to suboptimal treatment and outcomes for patients with rheumatic diseases, especially those with cancer. The training and research plans proposed here will allow her to develop critical skills in advanced pharmacoepidemiology and in qualitative research methods. Combined with an outstanding mentorship team, the University of Washington’s world-class facilities, and a rigorous training plan, this project will prepare Dr. Singh to successfully obtain future funding to adapt and test a decision aid for SDM implementation among patients with RA and an active or recent cancer.


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: 2025 ( Subtotal = $165,014 )
2025	2025	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	4	6/26/2025	NON-COMPETING CONTINUATION	$163,014
2025	2025	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	2/27/2025	SUPPLEMENT FOR EXPANSION	$2,000
														Subtotal = $165,014

Issue Date FY: 2024 ( Subtotal = $164,617 )
2024	2024	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	6/29/2024	NON-COMPETING CONTINUATION	$164,617
														Subtotal = $164,617

Issue Date FY: 2023 ( Subtotal = $164,924 )
2023	2023	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	8/2/2023	NON-COMPETING CONTINUATION	$164,924
														Subtotal = $164,924

Issue Date FY: 2022 ( Subtotal = $166,779 )
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	6/21/2022	NEW	$166,779
														Subtotal = $166,779

Grand Total All Awards = $661,334

Top

All Categories

About

Search

Reports

Data Submission

Award Information

Improving shared decision-making around the use of disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis and cancer

Award Number: K23AR079588

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/01/2022

PERIOD OF PERFORMANCE END DATE: 06/30/2027

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer