619 19Th Street South
Birmingham AL 35233
Medical School: Oregon Health Sciences University School Of Medicine - 1999
Accepts Medicare: No
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 24606
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Dr. Jeffrey Curtis is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:77080||Description:Dxa bone density axial||Average Price:$415.11||Average Price Allowed
|HCPCS Code:99205||Description:Office/outpatient visit new||Average Price:$438.12||Average Price Allowed
|HCPCS Code:99215||Description:Office/outpatient visit est||Average Price:$311.14||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$221.28||Average Price Allowed
|HCPCS Code:J1030||Description:Methylprednisolone 40 MG inj||Average Price:$11.90||Average Price Allowed
HCPCS Code Definitions
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
- Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
- Injection, methylprednisolone acetate, 40 mg
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
Medical Malpractice Cases
Medical Board Sanctions
Physical Medicine And Rehabilitation
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Curtis has made to other doctors
Age-Related Differences in Health-Related Quality of Life in COPD: An Analysis of the COPDGene and SPIROMICS Cohorts. - Chest
Younger persons with COPD report worse health-related quality of life (HRQL) than older individuals. The factors explaining these differences remain unclear.To explore factors associated with age-related differences in QOL in COPD.Cross-sectional analysis of participants with COPD, any GOLD grade of airflow limitation, â‰¥50 years-old in two cohorts: Genetic Epidemiology of COPD Study (COPDGene) and Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). We compared Saint George's Respiratory Questionnaire (SGRQ) scores by age group [middle-aged (age 50-64) versus older-adult (age 65-80)]. We used multivariate linear modeling to test associations of age with HRQL, adjusting for demographics, clinical characteristics and comorbidities.Among 4,097 participants in COPDGene (2,170 middle-aged and 1,927 older-adults) SGRQ total scores were higher (worse) among middle-aged (mean difference 4.2 points, 95%CI 2.8, 5.6, p<0.001) compared with older-adults. Age had a statistically significant interaction with dyspnea (p<0.001). Greater dyspnea severity (mMRC â‰¥2, compared with 0-1) had a stronger association with SGRQ score among middle-aged (Beta 24.6 [23.2, 25.9]) than in older-adult participants (Beta 21.0 [19.6, 22.3]). In analyses using SGRQ as outcome in 1,522 SPIROMICS participants (598 middle-aged and 924 older-adults), we found similar associations, confirming that for the same severity of dyspnea there is a stronger association with HRQL among younger individuals.Age-related differences in HRQL may be explained by a higher impact of dyspnea among younger COPD subjects.Copyright Â© 2015 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
The Risk for Cardiovascular Events Associated with Hyperlipdemia among Patients with and Without Rheumatoid Arthritis. - Journal of arthritis
To determine, using data from a real-world setting, the overall and sex-specific risk of cardiovascular (CV) events in patients with rheumatoid arthritis (RA), with or without comorbid hyperlipidemia, relative to those in a non-RA cohort.This retrospective cohort study using claims data from a US commercial health plan (2005-2011) included patients with RA and a matched non-RA cohort. Cox proportional hazards regression model determined the hazard ratio (HR) for CV events (myocardial infarction, stroke, revascularization procedures), using the presence of RA and hyperlipidemia as the independent variables, controlling for other covariates (age, sex, diabetes, and hypertension).The incidence of CV events per 1000 person-years was 10.19 for the RA cohort and 6.41 for the non-RA cohort (crude rate ratio [RR] =1.59). Within the RA cohort, incidence was 15.54 for patients with hyperlipidemia and 7.05 for patients without hyperlipidemia (crude RR=2.21); in the non-RA cohort, incidence was 10.55 and 3.82 for those with and without hyperlipidemia, respectively (crude RR=2.76). After controlling for covariates, the HR of CV events among RA patients was 1.68 (95% CI: 1.50, 1.87) relative to non-RA patients. After multivariable adjustment, hyperlipidemia conferred a significant risk of CV events in both RA and non-RA patients; the interaction between RA and hyperlipidemia was not significant (p=0.13).This real-world analysis demonstrates that patients with RA have an increased risk of CV events. Similar to a non-RA cohort, CV event rates were incrementally higher for those patients with hyperlipidemia.Cardiovascular disease is an increasingly visible topic of concern in the rheumatoid arthritis community. However, there are only limited data that informs both the absolute and relative rates of CVD events, and the contribution of various risk factors such as hyperlipidemia, compared to non-RA populationsThe 'lipid paradox' hypothesis in RA suggests that elevated LDL cholesterol has a negligible effect on CVD risk in RA, unlikely in the general population where it is a well-accepted CVD risk factorThe incidence of CVD events in RA patients was 10/1000 patient years, a 1.6 fold greater risk compared to non-RA patientsThe contribution of hyperlipidemia to CVD risk was associated with comparable or greater absolute increases in the rate of CV events compared to non RA patients, a finding that does not support the lipid paradox.
Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use. - Pharmacoepidemiology and drug safety
Medicare claims have been used to study lipid-lowering medication (LLM) use among US adults.We analyzed the agreement between Medicare claims for LLM and LLM use indicated by self-report during a telephone interview and, separately, by a medication inventory performed during an in-home study visit upon enrollment into the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We included REGARDS participants â‰¥65â€‰years enrolled in 2006-2007 with Medicare pharmacy benefits (Part D) from 120â€‰days before their telephone interview through their medication inventory (nâ€‰=â€‰899).Overall, 39.2% and 39.5% of participants had a Medicare claim for an LLM within 120â€‰days prior to their interview and medication inventory, respectively. Also, 42.7% of participants self-reported using LLMs, and 41.8% had an LLM in their medication inventory. The Kappa statistic (95% confidence interval [CI]) for agreement of Medicare claims with self-report and medication inventory was 0.68 (0.63-0.73) and 0.72 (0.68-0.77), respectively. No Medicare claims for LLMs were present for 22.1% (95%CI: 18.1-26.6%) of participants who self-reported taking LLMs and 18.9% (15.1-23.3%) with LLMs in their medication inventory. Agreement between Medicare claims and self-report was lower among Black male individuals (Kappaâ€‰=â€‰0.34 [95%CI: 0.14-0.54]) compared with Black female individuals (0.70 [0.61-0.79]), White male individuals (0.65 [0.56-0.75]), and White female individuals (0.79 [0.72-0.86]). Agreement between Medicare claims and the medication inventory was also low among Black male individuals (Kappaâ€‰=â€‰0.48 [95%CI: 0.29-0.66]).Although substantial agreement exists, many Medicare beneficiaries who self-report LLM use or have LLMs in a medication inventory have no claims for these medications. Copyright Â© 2016 John Wiley & Sons, Ltd.Copyright Â© 2016 John Wiley & Sons, Ltd.
Frequency of axial spondyloarthritis diagnosis among patients seen by United States rheumatologists for evaluation of chronic back pain. - Arthritis & rheumatology (Hoboken, N.J.)
Objective To determine the proportion of patients with axial spondyloarthritis (axSpA) among those with chronic back pain and â‰¥1 of 3 SpA features in the United States (US). Methods The study was conducted at rheumatology practices in the US. Patients were required to have chronic back pain for â‰¥3 months beginning at <45 years of age, and have â‰¥1 of 3 SpA features: 1) positive human leukocyte antigen B27 (HLA-B27), 2) current inflammatory back pain, 3) MRI/x-ray evidence of sacroiliitis, and no prior SpA diagnosis. Medical history/physical exam, pelvic x-ray, MRI of sacroiliac joints, CRP, and HLA-B27 were collected. Investigators were asked if a clinical diagnosis of axSpA could be made based upon results. Data were also analyzed separately to determine if patients fulfilled Assessment of SpondyloArthritis international Society (ASAS) criteria for axSpA and/or modified New York criteria for ankylosing spondylitis (AS). Results 751 patients were enrolled (46% existing patients in rheumatology practices, 40% new referrals, 14% self-referred). Among patients with available data, 319/697 (46%) were given a clinical diagnosis of axSpA by the investigator; 348/744 (47%) fulfilled ASAS criteria, of whom 238 were classified as non-radiographic axSpA, 108 as AS, and 2 had missing data. Using investigator's clinical diagnosis as the gold standard, specificity and sensitivity of the ASAS criteria were 79% and 81%, respectively. Conclusion Among patients with chronic back pain for â‰¥3 months beginning at age <45 years, the presence of â‰¥1 of 3 SpA features is an effective way to identify patients with possible axSpA. This article is protected by copyright. All rights reserved.Â© 2016, American College of Rheumatology.
Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis. - Annals of the rheumatic diseases
To compare the coronary heart disease risk among patients with rheumatoid arthritis (RA) initiating common biologic disease-modifying antirheumatic drugs of different mechanisms.We conducted a retrospective cohort study of patients with RA enrolled in Medicare, a public health plan covering >90% of US residents 65â€…years or older, from 2006 to 2012 who (1) initiated a biologic, (2) had complete medical and pharmacy coverage for at least 12â€…months before biologic initiation and (3) were free of coronary heart disease at the time of initiation. We compared the incidence rates (IRs) of (1) acute myocardial infarction (AMI) and (2) a composite outcome of AMI or coronary revascularisation and used multivariable adjusted Cox regression models to examine the associations between the type of biologic and the two outcomes.We identified 47â€…193 eligible patients with RA with mean age 64 (SD 13) years; 85% were women. Crude IRs for AMI ranged from 5.7 to 8.8 cases per 1000 person-years (PYs). AMI risk was significantly elevated among antitumour necrosis factor (anti-TNF) initiators overall (adjusted HR (aHR) 1.3; 95% CI 1.0 to 1.6) and individually among etanercept (aHR 1.3; 95% CI 1.0 to 1.8) and infliximab (aHR 1.3; 95% CI 1.0 to 1.6) compared with abatacept initiators. Crude IRs for the composite outcome ranged from 7.6 to 14.5 per 1000 PYs. Tocilizumab initiators were at reduced risk of the composite outcome compared with abatacept initiators (aHR 0.64, 95% CI 0.41 to 0.99).Findings from this observational study of patients with RA suggested that anti-TNF biologics may be associated with higher AMI risk compared with abatacept.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
MicroRNA-34a Negatively Regulates Efferocytosis by Tissue Macrophages in Part via SIRT1. - Journal of immunology (Baltimore, Md. : 1950)
Apoptotic cell (AC) clearance (efferocytosis) is an evolutionarily conserved process essential for immune health, particularly to maintain self-tolerance. Despite identification of many recognition receptors and intracellular signaling components of efferocytosis, its negative regulation remains incompletely understood and has not previously been known to involve microRNAs (miRs). In this article, we show that miR-34a (gene ID 407040), well recognized as a p53-dependent tumor suppressor, mediates coordinated negative regulation of efferocytosis by resident murine and human tissue macrophages (MÃ¸). The miR-34a expression varied greatly between MÃ¸ from different tissues, correlating inversely with their capacity for AC uptake. Transient or genetic knockdown of miR-34a increased efferocytosis, whereas miR-34a overexpression decreased efferocytosis, without altering recognition of live, necrotic, or Ig-opsonized cells. The inhibitory effect of miR-34a was mediated both by reduced expression of Axl, a receptor tyrosine kinase known to recognize AC, and of the deacetylase silent information regulator T1, which had not previously been linked to efferocytosis by tissue MÃ¸. Exposure to AC downregulated MÃ¸ miR-34a expression, resulting in a positive feedback loop that increased subsequent capacity to engulf AC. These findings demonstrate that miR-34a both specifically regulates and is regulated by efferocytosis. Given the ability of efferocytosis to polarize ingesting MÃ¸ uniquely and to reduce their host-defense functions, dynamic negative regulation by miR-34a provides one means of fine-tuning MÃ¸ behavior toward AC in specific tissue environments with differing potentials for microbial exposure.Copyright Â© 2016 by The American Association of Immunologists, Inc.
Population Variations in Rheumatoid Arthritis Treatment and Outcomes, Northern California, 1998-2009. - The Permanente journal
To assess variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009.The study used computerized data from 16 Kaiser Permanente Northern California Medical Centers. Mixed modeling was used to assess patterns across time and clinic. The analysis accounted for patient demographics, clustering of patients within Medical Centers, and repeated measures of patients over time. The metric used to measure drug use, months of use per patient per year, included both users and nonusers in the denominator, to account for both prevalence and duration of use.Assessment was performed of 28,601 patients with rheumatoid arthritis, with all levels of severity. From 1998 through 2009, methotrexate use doubled in the typical patient to include 23% of the time they were observed; sulfasalazine and hydrochloroquine use declined. By 2008 through 2009, leflunomide and antitumor necrosis factor agents were used by the typical patient 4% and 9% of the time, respectively. Between 1998 and 2009, disease-modifying antirheumatic drug use increased in the typical patient from 38% to 63% of the time, and oral prednisone use declined from 23% to 15% of the time, whereas opioid use initially rose but then fell to 23% of the time. No variations over time were observed for the rate of hospitalized pneumonia or opportunistic infection. Variation across clinics, measured by the difference in drug use between clinics at the 75th and 25th percentiles, was lowest for opioids (25% vs 20% of the time) and greatest for infliximab (< 1% to 3%).Increased use of disease-modifying antirheumatic drugs and declines in prednisone are encouraging. Opioid use may need intervention.
Association of Triple Therapy With Improvement in Cholesterol Profiles Over Two-Year Followup in the Treatment of Early Aggressive Rheumatoid Arthritis Trial. - Arthritis & rheumatology (Hoboken, N.J.)
To evaluate long-term changes in cholesterol levels in patients with early rheumatoid arthritis (RA) who were randomized to begin treatment with methotrexate (MTX) monotherapy, MTX plus etanercept, or triple therapy (MTX plus sulfasalazine plus hydroxychloroquine) in the Treatment of Early Aggressive Rheumatoid Arthritis (TEAR) trial.Levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol were analyzed in 416 patients participating in the TEAR trial, during 102 weeks of followup. Associations of cholesterol changes with disease activity and drug treatment were evaluated using repeated-measures analysis with mixed-effect linear models to model within-subject covariance over time.Mixed-effect models controlling for traditional cardiovascular (CV) risk factors, TEAR treatment, and baseline prednisone and statin use demonstrated significant inverse associations of RA disease activity with changes in cholesterol over time. Decreases in the 28-joint Disease Activity Score, the C-reactive protein level, or the erythrocyte sedimentation rate were associated with increases in levels of HDL cholesterol, LDL cholesterol, and total cholesterol in all treatment groups (P < 0.001-0.035). Triple therapy was strongly associated with higher levels of HDL cholesterol, lower levels of LDL cholesterol, and higher ratios of total cholesterol:HDL cholesterol (P < 0.001 for all) compared to MTX monotherapy or MTX plus etanercept therapy over the 2-year followup.Decreases in RA disease activity over long-term followup were associated with increases in cholesterol levels in patients with early RA treated with either biologic or nonbiologic therapies. The use of triple therapy during 2 years of followup was associated with higher HDL cholesterol levels, lower LDL cholesterol levels, and lower total cholesterol:HDL cholesterol ratios compared to those observed in patients who received MTX monotherapy or MTX plus etanercept combination therapy. Additional studies are needed to assess the effects of these cholesterol changes on CV events in patients with RA.Â© 2016, American College of Rheumatology.
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor Î± agents, a retrospective cohort study. - Arthritis research & therapy
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFÎ±) agents or alternate mechanisms of action (MOAs) (e.g., T-cell, B-cell, and interleukin-6 inhibitors).RA patients at least 18 years old were selected from the MarketScan databases (2010-2012) if they had at least one prescription/administration of abatacept, rituximab, tocilizumab, or anti-TNF after having discontinued a different biologic agent and meeting enrollment criteria. Cox models estimated the risk of incident ILD and ILD-related hospitalization. Sensitivity analyses used an alternate ILD case definition.We identified 13,795 episodes of biologic exposure in 11,219 patients. Mean (standard deviation) follow-up was 0.7 (0.5) years. Patients receiving alternate MOA agents were more likely to have had recent exposure to steroids, prior exposure to a greater number of biologics, and history of ILD, anemia, chronic obstructive pulmonary disease, and other pulmonary conditions. When the sensitive definition was used, unadjusted ILD incidence rates (95% confidence interval, or CI) ranged from 4.0 (1.6-8.2, abatacept) to 12.2 (5.6-23.2, infliximab) per 1000 person-years. Being older (hazard ratio (HR) 3.5; 95% CI 2.1-6.0), being male (HR 3.1; 95% CI 1.2-8.4), and having another pulmonary condition (HR 4.8; 95% CI 1.7-13.7) were associated with increased ILD incidence in either sensitive and/or specific models. There were no significant differences by biologic class. Hospitalization rates (95% CI) when the sensitive definition was used ranged from 55.6 (6.7-200.7, tocilizumab) to 262.5 (71.5-672.2, infliximab). In Cox models, recent methotrexate exposure was associated with reduced ILD hospitalization (HR 0.16; 95% CI 0.06-0.46), whereas being male (HR 2.5; 95% CI 1.3-4.8) and having had a hospitalization for asthma (HR 3.4; 95% CI 1.2-9.8) or ILD/pneumonia (HR 2.3; 95% CI 1.1-4.7) in the 12 months prior to index were associated with increased hospitalization risk.There were no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFÎ± agents and those receiving alternate MOA agents. Further studies are needed that account for differences in baseline characteristics in order to fully evaluate the risk of ILD and its complications.
Increased pretreatment serum IFN-Î²/Î± ratio predicts non-response to tumour necrosis factor Î± inhibition in rheumatoid arthritis. - Annals of the rheumatic diseases
Studies suggest that circulating type I interferon (IFN) may predict response to biological agents in rheumatoid arthritis (RA). Prediction of response prior to initiating therapy would represent a major advancement.We studied sera from a test set of 32 patients with RA from the Auto-immune Biomarkers Collaborative Network Consortium and a validation set of 92 patients with RA from the Treatment Efficacy and Toxicity in Rheumatoid Arthritis Database and Repository registry. The test set included those with good response or no response to tumour necrosis factor (TNF) inhibitors at 14â€…weeks by European League Against Rheumatism criteria. The validation set included subjects with good, moderate or no response at 12â€…weeks. Total serum type I IFN activity, IFN-Î± and IFN-Î² activity were measured using a functional reporter cell assay.In the test set, an increased ratio of IFN-Î² to IFN-Î± (IFN-Î²/Î± activity ratio) in pretreatment serum associated with lack of response to TNF inhibition (p=0.013). Anti-cyclic citrullinated peptide antibody titre and class of TNF inhibitor did not influence this relationship. A receiver-operator curve supported a ratio of 1.3 as the optimal cut-off. In the validation set, subjects with an IFN-Î²/Î± activity ratio >1.3 were significantly more likely to have non-response than good response (OR=6.67, p=0.018). The test had 77% specificity and 45% sensitivity for prediction of non-response compared with moderate or good response. Meta-analysis of test and validation sets confirmed strong predictive capacity of IFN-Î²/Î± activity ratio (p=0.005).Increased pretreatment serum IFN-Î²/Î± ratio strongly associated with non-response to TNF inhibition. This study supports further investigation of serum type I IFN in predicting outcome of TNF inhibition in RA.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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