Scholars@Duke
Mithunan Maheswaranathan

Mithunan Maheswaranathan

Assistant Professor of Medicine
Medicine, Rheumatology and Immunology

Selected Publications

Association of Limited Health Literacy With Clinical and Patient-Reported Outcomes in Individuals With Systemic Lupus Erythematosus.

Journal Article ACR Open Rheumatol · November 2024 OBJECTIVE: Health literacy is an important social determinant of health, with limited health literacy associated with worse health outcomes. This study examined the associations between limited health literacy with patient-reported outcomes and disease act ... Full text Link to item Cite

Patient and Physician Perspectives of Systemic Lupus Erythematosus Flare: A Qualitative Study.

Journal Article J Rheumatol · May 1, 2024 OBJECTIVE: Systemic lupus erythematosus (SLE) flares are associated with increased damage and decreased health-related quality of life. We hypothesized that there is discordance between physicians' and patients' views of SLE flare. In this study, we aimed ... Full text Link to item Cite

Interpreting hydroxychloroquine blood levels for medication non-adherence: a pharmacokinetic study.

Journal Article Lupus Sci Med · April 30, 2024 OBJECTIVE: Characterise the relationship between hydroxychloroquine (HCQ) blood levels and the number of missed doses, accounting for dosage, dose timing and the large variability in pharmacokinetics (PK) between patients. METHODS: We externally validated ... Full text Link to item Cite

Evaluation of Type 2 SLE symptoms in patients with a range of lupus nephritis activity.

Journal Article Clin Rheumatol · April 2024 BACKGROUND: Type 2 systemic lupus erythematosus (SLE) symptoms, including fatigue, fibromyalgia, and brain fog, contribute to poor health-related quality of life (HRQoL) in patients with lupus. To test the hypothesis that Type 1 (classical inflammatory lup ... Full text Link to item Cite

The Type 1 & 2 systemic lupus erythematosus model: Perspectives of people living with systemic lupus erythematosus.

Journal Article Lupus · March 2024 OBJECTIVE: In the new Type 1 & 2 model for systemic lupus erythematosus (SLE), Type 1 SLE represents classic inflammatory manifestations, such as arthritis, while Type 2 SLE encompasses symptoms such as pain and fatigue where the relationship to inflammati ... Full text Link to item Cite

Patient perspectives on telemedicine use in rheumatology during the COVID-19 pandemic: survey results from the COVID-19 Global Rheumatology Alliance.

Journal Article Clin Rheumatol · January 2024 OBJECTIVE: The COVID-19 pandemic resulted in rapid adoption of telemedicine in rheumatology. We described perspectives of patients with rheumatic diseases related to telemedicine use. METHODS: An anonymous online survey for people with rheumatic diseases w ... Full text Link to item Cite

Development and psychometric evaluation of a physician global assessment for type 2 systemic lupus erythematosus symptoms.

Journal Article Lupus Sci Med · December 17, 2023 OBJECTIVE: Manifestations of SLE can be categorised as type 1 (classic signs and symptoms of SLE) or type 2 (fatigue, widespread pain and brain fog with an unclear relationship to inflammation). While measures of type 1 SLE activity exist, most current phy ... Full text Link to item Cite

Pilot Intervention to Improve Medication Adherence Among Patients With Systemic Lupus Erythematosus Using Pharmacy Refill Data.

Journal Article Arthritis Care Res (Hoboken) · March 2023 OBJECTIVE: Despite high rates of medication nonadherence among patients with systemic lupus erythematosus (SLE), effective interventions to improve adherence in SLE are limited. We aimed to assess the feasibility of a pilot intervention and explore its eff ... Full text Open Access Link to item Cite

Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications.

Conference Arthritis Care Res (Hoboken) · January 2023 OBJECTIVE: Medication nonadherence is common among patients with systemic lupus erythematosus (SLE), and adherence often fluctuates with time. Underrepresented racial minorities have disproportionately lower rates of medication adherence and more severe SL ... Full text Link to item Cite

Development and Initial Validation of a Systemic Lupus Erythematosus-Specific Measure of the Extent of and Reasons for Medication Nonadherence.

Journal Article J Rheumatol · December 2022 OBJECTIVE: Medication nonadherence is common in patients with systemic lupus erythematosus (SLE) and negatively affects outcomes. To better recognize and address nonadherence in this population, there is a need for an easily implementable tool with interpr ... Full text Link to item Cite

Intermittent and Persistent Type 2 lupus: patient perspectives on two distinct patterns of Type 2 SLE symptoms.

Journal Article Lupus Sci Med · August 2022 OBJECTIVE: We have developed a new conceptual model to characterise the signs and symptoms of SLE: the Type 1 and 2 SLE Model. Within the original model, Type 1 SLE consists of inflammatory manifestations like arthritis, nephritis and rashes; Type 2 SLE in ... Full text Link to item Cite

Association of Health Literacy and Numeracy With Lupus Knowledge and the Creation of the Lupus Knowledge Assessment Test.

Journal Article J Rheumatol · June 2022 OBJECTIVE: Limited health literacy and numeracy are associated with worse patient-reported outcomes and higher disease activity in systemic lupus erythematosus (SLE), but which factors may mediate this association is unknown. We sought to determine the ass ... Full text Link to item Cite

A 79-Year-Old Female Patient With Altered Mental Status and Anemia.

Journal Article Arthritis Care Res (Hoboken) · April 2022 Full text Link to item Cite

Real world utilization of the myositis autoantibody panel.

Journal Article Clin Rheumatol · August 2021 OBJECTIVE: Myositis autoantibody panel results can offer diagnostic and prognostic information in patients with concern for idiopathic inflammatory myopathy (IIM). However, there has been widespread utilization of myositis autoantibody testing clinically, ... Full text Link to item Cite

Low health numeracy is associated with higher disease activity in systemic lupus erythematosus.

Journal Article Lupus · March 2021 OBJECTIVE: Evidence suggests low health literacy is prevalent in the United States and associated with worse clinical outcomes, yet few studies have investigated health literacy in systemic lupus erythematosus (SLE). The objective of this study was to dete ... Full text Link to item Cite

Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review.

Journal Article Curr Allergy Asthma Rep · November 12, 2020 PURPOSE OF REVIEW: Inadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is to review studies investigating health literacy and its association ... Full text Link to item Cite

Identification and Management of the Hypervirulent Invasive Klebsiella pneumoniae Syndrome: A Unique and Distinct Clinical Entity.

Journal Article J Investig Med High Impact Case Rep · 2018 In this article, we describe the case of a 61-year-old woman who presented with altered mental status and was found to have Klebsiella pneumoniae meningitis, bacteremia, and hepatic abscess. Despite intravenous antibiotic therapy and percutaneous drainage ... Full text Link to item Cite

Platelet-derived growth factor (PDGF) regulates Slingshot phosphatase activity via Nox1-dependent auto-dephosphorylation of serine 834 in vascular smooth muscle cells.

Journal Article J Biol Chem · October 14, 2011 Migration of vascular smooth muscle cells (VSMCs) contributes to vascular pathology. PDGF induces VSMC migration by a Nox1-based NADPH oxidase mediated mechanism. We have previously shown that PDGF-induced migration in VSMCs requires Slingshot-1L (SSH1L) p ... Full text Link to item Cite