James P Franciosi, MD
GastroenterologyInsurance Accepted
- Aetna Better Health FL Medicaid and Healthy Kids
- Aetna HMO/POS/PPO/EPO
- AmeriHealth Caritas Florida (FKA Prestige Health Choice)
- AvMed
- Blue Cross and Blue Shield HMO
- Blue Cross and Blue Shield Non HMO
- Blue Cross Blue Shield Florida Blue Select
- Cigna & Great West HMO/POS Open Access
- Cigna & Great West PPO/EPO
- Community Care Plan Medicaid
- Employers Health Network PPO
- Evolutions Healthcare
- First Health Aetna PPO/EPO
- Florida Medicaid
- Florida Medicare
- Health First Health Plans
- HealthSmart Health Plans PPO
- HUMANA HEALTHY HORIZONS (FKA HUMANA MEDICAID)
- Humana HMO/POS
- Humana PPO/EPO
- Molina Healthcare Medicaid
- Multiplan PPO
- Olympus Managed Healthcare PPO ORL
- Prime Health Services PPO Specialty Florida
- Seminole Tribe of Florida
- Simply Healthcare Healthy Kids
- Simply Healthcare Medicaid HMO
- Star Healthcare Network
- Sunshine SMI/CMS 19 & 21
- Sunshine State Health Plan Medicaid
- Three Rivers Provider Network
- Tricare/Humana Military Health Services
- United Healthcare Commercial Products
- United Healthcare Community Plan Medicaid
- Volusia Health Network PPO/EPO
- Celiac Disease
- Eosinophilic Esophagitis
- Feeding Disorders
- Inflammatory Bowel Disease
Research Activities
I serve as Associate Chief of the Division of Gastroenterology, Hepatology, and Nutrition at Nemours Children’s Hospital. My research focus is in pediatric Eosinophilic Esophagitis (EoE), with five first or co-authored publications on this topic in 2012. EOE is a rapidly emerging, chronic esophageal condition, as our understanding of disease pathogenesis is evolving. Specifically, the second iteration of Eosinophilic Esophagitis Consensus Guidelines, was published in 2011, makes distinctions between esophageal eosinophilia subtypes of confirmed EoE, gastroesophageal reflux disease and proton pump inhibitor (PPI) responsive esophageal eosinophilia. The mechanisms by which these different disease processes are generated are not fully understood. As these definitions are largely based on patients’ histopathological response to a clinical trial of PPI therapy, one consideration may be in the pharmacogenetic profiles of the PPI medications themselves. Recently, researchers at Nemours have shown that the pharmacokinetics and pharmacodynamics of PPIs are influenced by genetic polymorphisms that are associated with adverse respiratory events. Several variant alleles are loss-of-function alleles resulting in reduced drug clearance and in individuals being classified as poor metabolizers (PM); other alleles are associated with more rapid clearance and are responsible for the extensive metabolizers (EM) phenotype. Improved characterization of esophageal eosinophilia subtypes through PPI genotype characterization may allow for more rapid diagnosis and appropriate medical intervention. In addition, judicious use of PPI medications among patients with esophageal eosinophilia through personalized medicine techniques of genotype will also lessen the potential adverse impact of PPI-associated morbidity.
Medical Interests
- Eosinophilic GI disease and digestive tract food allergy
- Health outcomes (looking at how doctors can make life better for patients and their families)
- Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
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Comparative Effectiveness of Intravenous Azithromycin Versus Erythromycin Stimulating Antroduodenal Motility in Children.; Journal of pediatric gastroenterology and nutrition; (2022).
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Pharmacogenomics fail to explain proton pump inhibitor refractory esophagitis in pediatric esophageal atresia.; Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society; (2021).
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A Provider-Focused Intervention to Promote Optimal Care of Pediatric Patients With Suspected Elbow Fracture.; Pediatric emergency care; (2021).
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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing.; Clinical pharmacology and therapeutics; (2020).
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COVID-19-A Guide to Rapid Implementation of Telehealth Services: A Playbook for the Pediatric Gastroenterologist.; Journal of pediatric gastroenterology and nutrition; (2020).
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STAT6 Variants Associate With Relapse of Eosinophilic Esophagitis in Patients Receiving Long-term Proton Pump Inhibitor Therapy.; Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association; (2020).
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Promoting Adherence to Influenza Vaccination Recommendations in Pediatric Practice.; Journal of primary care & community health; (2019).
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CYP2C19 and STAT6 Variants Influence the Outcome of Proton Pump Inhibitor Therapy in Pediatric Eosinophilic Esophagitis.; Journal of pediatric gastroenterology and nutrition; (2019).
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Genotype tailored treatment of mild symptomatic acid reflux in children with uncontrolled asthma (GenARA): Rationale and methods.; Contemporary clinical trials; (2019).
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Symptom Burden and Quality of Life Over Time in Pediatric Eosinophilic Esophagitis.; Journal of pediatric gastroenterology and nutrition; (2019).
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Challenges and lessons learned from clinical pharmacogenetic implementation of multiple gene-drug pairs across ambulatory care settings.; Genetics in medicine : official journal of the American College of Medical Genetics; (2019).
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Provider-Focused Intervention to Promote Comprehensive Screening for Adolescent Idiopathic Scoliosis by Primary Care Pediatricians.; American journal of medical quality : the official journal of the American College of Medical Quality; (2018).
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Novel Implementation of Genotype-Guided Proton Pump Inhibitor Medication Therapy in Children: A Pilot, Randomized, Multisite Pragmatic Trial.; Clinical and translational science; (2018).
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Association Between CYP2C19*17 Alleles and pH Probe Testing Outcomes in Children With Symptomatic Gastroesophageal Reflux.; Journal of clinical pharmacology; (2017).
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Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease.; Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation; (2017).
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Association between CYP2C19 extensive metabolizer phenotype and childhood anti-reflux surgery following failed proton pump inhibitor medication treatment.; European journal of pediatrics; (2017).
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- English