Gout affects ~1 to 2% of the U.S. population. With an aging population, the societal burden of gout will likely grow. The role of genetic factors on gout and hyperuricemia among different races/ethnicities and the mechanisms by which treatment of hyperuricemia may impact vascular disease remain poorly understood. While the causes of hyperuricemia are known, and efficacious treatments for gout are available, there are large gaps in the quality of care of gout patients. These care gaps, the societal impact of gout, and rising concerns about deleterious effects of hyperuricemia make these conditions ideal targets for translational research. Our multi-disciplinary UAB CORT includes 4 research projects and an administrative core focused on the theme of """"""""Gout and Hyperuricemia: from Bench to Bedside to Backyard. Gout, hyperuricemia, and vascular disease are more common among African Americans than Caucasians, yet little is known about genetic and environmental factors associated with increased risk of gout in this minority population. Our four projects are thus further united by a sub-theme of racial/ethnic disparities in gout and hyperuricemia. We will analyze the association of gout and hyperuricemia with cardiovascular disease in African-Americans and define genetic variants and environmental and medical factors underlying hyperuricemia and gout in this minority group (Project 1);characterize biomarkers of inflammation (CRP), vascular disease (endothelial function), and blood pressure changes associated with the ULT allopurinol (Project 2);examine factors associated with suboptimal gout care and factors influencing effective and safer dosing of allopurinol and colchicine in African-Americans and Caucasians (Project 3);and compare the effectiveness of a novel pharmacy-based """"""""virtual"""""""" Gout Clinic that includes protocol-driven care to usual care in the treatment of chronic gout (Project 4). The overall goal of our CORT is to improve the health of patients with gout and hyperuricemia by applying scientifically rigorous, state-of-the-art methodology to clinically important questions in translational investigation and to educate clinical investigators through an enrichment program. Drawing on the unique strengths of many UAB Centers, Departments, and Programs, and in collaboration with an experienced team of 20 investigators representing 5 disciplines, our innovative projects hold the promise of significant improvements in our understanding of the pathogenesis of gout, hyperuricemia, and related co-morbid conditions, and may ultimately lead to better ways to predict, treat, or prevent gout and hyperuricemia.

Public Health Relevance

Gout and high serum urate levels are common in the general population, as are associated conditions such as cardiovascular disease. A better understanding of the genetic and environmental influences on gout, and hyperuricemia in different races/ethnicities would ultimately improve public health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Specialized Center (P50)
Project #
1P50AR060772-01A1
Application #
8335625
Study Section
Special Emphasis Panel (ZAR1-KM (M1))
Program Officer
Witter, James
Project Start
2012-09-01
Project End
2017-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
1
Fiscal Year
2012
Total Cost
$1,147,381
Indirect Cost
$283,862
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Singh, Jasvinder A; Ramachandaran, Rekha (2016) Does rural residence impact total ankle arthroplasty utilization and outcomes? Clin Rheumatol 35:381-6
Saddekni, Michael B; Saag, Kenneth G; Dudenbostel, Tanja et al. (2016) The effects of urate lowering therapy on inflammation, endothelial function, and blood pressure (SURPHER) study design and rationale. Contemp Clin Trials 50:238-44
Coburn, Brian W; Cheetham, T Craig; Rashid, Nazia et al. (2016) Rationale and design of the randomized evaluation of an Ambulatory Care Pharmacist-Led Intervention to Optimize Urate Lowering Pathways (RAmP-UP) Study. Contemp Clin Trials 50:106-15
Singh, Jasvinder A; Yu, Shaohua (2016) Gout-related inpatient utilization: a study of predictors of outcomes and time trends. Arthritis Res Ther 18:57
Singh, Jasvinder A; Ramachandran, Rekha (2016) Time trends in total ankle arthroplasty in the USA: a study of the National Inpatient Sample. Clin Rheumatol 35:239-45
Reynolds, Richard J; Vazquez, Ana I; Srinivasasainagendra, Vinodh et al. (2016) Serum urate gene associations with incident gout, measured in the Framingham Heart Study, are modified by renal disease and not by body mass index. Rheumatol Int 36:263-70
Singh, Jasvinder A; Yu, Shaohua (2016) Utilization due to chronic obstructive pulmonary disease and its predictors: a study using the U.S. National Emergency Department Sample (NEDS). Respir Res 17:1
Singh, Jasvinder A; Yu, Shaohua (2016) Time Trends, Predictors, and Outcome of Emergency Department Use for Gout: A Nationwide US Study. J Rheumatol 43:1581-8
Singh, Jasvinder A; Qu, Haiyan; Yazdany, Jinoos et al. (2015) Barriers to Medication Decision Making in Women with Lupus Nephritis: A Formative Study using Nominal Group Technique. J Rheumatol 42:1616-23
Singh, Jasvinder A; Ramachandran, Rekha (2015) Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US? Arthritis Care Res (Hoboken) 67:885-90

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