Faculty of Medical and Health Sciences


Gout studies


Preventing gout attacks


nicola dalbeth 2015

Professor Lisa Stamp, University of Otago, Christchurch - Principal Investigator

Professor Nicola Dalbeth - Principal Investigator

Dr Anne Horne - Study Coordinator

Thrishila Parshu Ram - Study Coordinator

Bobby Mihov - Study Coordinator

Gout is a common and challenging problem. Gout is particularly common in New Zealand. High levels of uric acid in the blood are the main cause of gout.

For gout to be controlled uric acid levels need to be below 0.36mmol/l or 0.30mmol/l for people who have more severe disease. If the target level is achieved over the long term the number of attacks of gout will reduce and stop and tophi will dissolve.

Long-term urate lowering therapy is required to reduce serum urate. However, commencement and increasing the dose of urate lowering therapy can be associated with gout attacks. It is therefore recommended that patients receive another medication to protect against acute attacks when commencing urate lowering therapy. Urate-lowering medications such as allopurinol are now started at low doses and increased slowly. This approach may mean that not everyone who starts allopurinol will need another medication to prevent acute attacks. Low-dose colchicine is one medication recommended for preventing gout flares. We want to find out if low dose colchicine reduces gout flares compared to a placebo when starting allopurinol.

This study has been funded by the Health Research Council of New Zealand and has received ethical approval from the New Zealand Health and Disability Ethics Committee.

Recruitment is ongoing for this study.

 

 

Please feel free to contact the researchers if you have any questions about this study.

Bone & Joint Research Group 
University of Auckland 
Auckland Hospital 
Private Bag 92 024 
Auckland 

Dr Anne Horne
Phone: +64 9 923 9787
Email: a.horne@auckland.ac.nz

Bobby Mihov
Email: b.mihov@auckland.ac.nz

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Intensive urate-lowering therapy for bone erosion in gout


nicola dalbeth 2015

Professor Nicola Dalbeth - Principal Investigator

Thrishila Parshu Ram - Study Coordinator

Gout is a disorder of urate metabolism characterized by intra-articular deposition of monosodium urate (MSU) crystals. In the presence of prolonged hyperuricaemia, some patients with gout develop advanced disease, characterised by tophi (collections of MSU crystals), chronic arthritis and structural joint damage. Focal bone loss, or bone erosion, is the central feature of structural joint damage in tophaceous gout. Over time, these pathological changes may lead to joint deformity and disability. Our research has implicated MSU crystals in the development of bone erosion in gout. Advanced imaging studies have demonstrated a close relationship between tophi and sites of bone erosion.

At present, the recommended serum urate target for people with erosive gout is <0.30mmol/L. This level allows slow regression of subcutaneous and intra-articular tophi. However, the optimal therapeutic target for people with advanced gout has not been assessed in clinical trials to date. In particular, there are no clinical trial data to determine the optimal therapeutic target for treatment of bone erosion due to gout.

This study aims to examine the efficacy of intensive urate-lowering therapy for treatment of bone erosion in people with gout. The study hypothesis is that intensive oral urate-lowering therapy to maintain serum urate concentrations <0.20mmol/L results in healing of bone erosion as evidence by improved bone erosion scores in people with erosive gout.

Recruitment is complete for this study.

Please feel free to contact the researchers if you have any questions about this study

Bone & Joint Research Group 
University of Auckland 
Auckland Hospital 
Private Bag 92 024 
Auckland 

Thrishila Parshu Ram
Phone: +64 9 923 3133
Email: t.parshuram@auckland.ac.nz

 

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Finding the genes for gout and its treatment


nicola dalbeth 2015

Professor Nicola Dalbeth - Principal Investigator

Dr Anne Horne - Study Coordinator

Thrishila Parshu Ram - Study Coordinator

Bobby Mihov - Study Coordinator

Gout is common a common form of arthritis affecting about 5% of the New Zealand adult population. It causes attacks of severe joint pain. In the longer term, the joints can become permanently damaged. Allopurinol is the most common drug used to treat gout. However many people continue to have attacks of gout. It’s been known for a long time that gout is partly genetic because of certain genes that we inherit from our parents. We want to find out what these genes are, and how they cause the disease. We also want to find out why some people do not respond well to the drug allopurinol, which is used to treat gout. This may be because certain genes influence the way the allopurinol works. This involves looking at the DNA, the genetic code material found inside the blood. DNA from people with gout is needed.

Recruitment is ongoing for this study.

Please feel free to contact the researchers if you have any questions about this study.

Bone & Joint Research Group 
University of Auckland 
Auckland Hospital 
Private Bag 92 024 
Auckland 

Dr Anne Horne
Phone: +64 9 923 9787
Email: a.horne@auckland.ac.nz

Thrishila Parshu Ram
Phone: +64 9 923 3133
Email: t.parshuram@auckland.ac.nz

Bobby Mihov
Phone: +64 9 923 4100
Email: b.mihov@auckland.ac.nz

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Finding the genes for gout: the effect of inosine.


nicola dalbeth 2015

Professor Nicola Dalbeth - Principal Investigator

Gout is caused by high uric acid levels in the blood and can lead to pain, swelling and stiffness of the joints. Eating or drinking foods with a lot of purines can increase the uric acid levels and the risk of gout.

This study is seeking people who are generally in good health without gout, to take study the effects of a purine nutritional supplement called inosine on uric acid levels. The study is intended to find out how our genes influence the ability of purines to increase the blood uric acid levels.

Recruitment is complete for this study.

Please feel free to contact the researchers if you have any questions about this study.

Bone & Joint Research Group 
University of Auckland 
Auckland Hospital 
Private Bag 92 024 
Auckland 

Dr Anne Horne
Phone: +64 9 923 9787
Email: a.horne@auckland.ac.nz

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