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.
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.
|Taylor, William J; Redden, David; Dalbeth, Nicola et al. (2014) Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout. J Rheumatol 41:574-80|
|Kirwan, John R; Boers, Maarten; Hewlett, Sarah et al. (2014) Updating the OMERACT filter: core areas as a basis for defining core outcome sets. J Rheumatol 41:994-9|
|Stamp, Lisa K; Merriman, Tony R; Barclay, Murray L et al. (2014) Impaired response or insufficient dosage? Examining the potential causes of "inadequate response" to allopurinol in the treatment of gout. Semin Arthritis Rheum 44:170-4|
|(2014) Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384:1005-70|
|Singh, Jasvinder A; Lewallen, David G (2014) Time trends in the characteristics of patients undergoing primary total knee arthroplasty. Arthritis Care Res (Hoboken) 66:897-906|
|Dalbeth, Nicola; Zhong, Cathy S; Grainger, Rebecca et al. (2014) Outcome measures in acute gout: a systematic literature review. J Rheumatol 41:558-68|
|Sattui, Sebastian E; Singh, Jasvinder A; Gaffo, Angelo L (2014) Comorbidities in patients with crystal diseases and hyperuricemia. Rheum Dis Clin North Am 40:251-78|
|Singh, Jasvinder A (2014) Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study. Arthritis Res Ther 16:R82|
|Singh, Jasvinder A (2014) The impact of gout on patient's lives: a study of African-American and Caucasian men and women with gout. Arthritis Res Ther 16:R132|
|Singh, Jasvinder A; Taylor, William J; Dalbeth, Nicola et al. (2014) OMERACT endorsement of measures of outcome for studies of acute gout. J Rheumatol 41:569-73|
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