Publications by authors named "Dalbeth N"
Objectives: The dynamics of monosodium urate (MSU) crystal changes across a range of serum urate concentrations in people with gout are unknown. This study aimed to systematically examine the relationship between serum urate and changes in dual-energy CT (DECT) urate volume in people with gout and stable serum urate concentrations.
Methods: Individual participant data were analysed from three studies of people with gout.
Dyslipidemia affects approximately half of all people with gout, and prior Mendelian randomization analysis suggested a causal role for elevated triglycerides in hyperuricemia (HU), but the underlying mechanisms remain elusive. We hypothesize that dyslipidemia promotes hepatic urate biosynthesis in HU and gout and fatty acid (FA) oxidation (FAO) drives this process. Here we developed a targeted metabolomics to quantify major metabolites in purine metabolic pathway in the sera of a human cohort with HU, gout, and normaluricemic controls.
View Article and Find Full Text PDFRelationship Between Gout Flare States and Patient-Reported Outcomes After Allopurinol Initiation.
Arthritis Care Res (Hoboken)
January 2025
Article Synopsis
- Gout flares are crucial indicators of the disease's impact, with specific maximum flare counts linked to acceptable symptom states (PASS) and low disease activity (LDA).
- A study analyzed data from 179 gout patients over 12 months, focusing on flare occurrences and assessing their impact on patient-reported outcomes, including quality of life and illness perception.
- Results showed that while many participants achieved either PASS or LDA, increased flare frequency correlated with higher negative impacts on patients, emphasizing the need for effective flare prevention strategies in gout management.
Background: Patients' negative expectations about medication can exacerbate side effect burden leading to low adherence and persistence. A novel intervention involves targeting mindsets about non-severe symptoms; reframing them as encouraging signs of medication working.
Purpose: This study aimed to assess whether a brief symptom-mindset intervention can improve symptom experience and adherence in patients starting methotrexate to treat an inflammatory rheumatic disease.
Gout flares after stopping anti-inflammatory prophylaxis: a rapid literature review and meta-analysis.
Arthritis Care Res (Hoboken)
December 2024
Objective: The aim of this research was to determine how common gout flares are after ceasing anti-inflammatory prophylaxis.
Methods: A rapid literature review and meta-analysis were undertaken. PubMed was searched from inception to February 2024.
Importance: Clinicians often approach urate-lowering therapy (ULT) cautiously in patients with gout and impaired kidney function because they are concerned about the risk of progression to severe or end-stage kidney disease. However, evidence from randomized clinical trials of this association remains inconclusive.
Objective: To evaluate the association between achieving target serum urate level with ULT and progression of chronic kidney disease (CKD) to severe or end-stage in patients with gout and impaired kidney function.
Objective: Evidence for an association of smoking with gout is conflicting. We assessed associations of current and past smoking with gout in an Aotearoa New Zealand (NZ) population.
Methods: Multivariable logistic regression analysis was performed on cross-sectional data from participants of NZ Māori (from 2 studies: Genetics of Gout in Aotearoa [GGA] study of 293 participants with gout and 431 without; and Ngāti Porou Hauora [NPH] study of 111 participants with gout and 42 without), Pacific people (257 participants with gout and 357 without), and European (694 participants with gout and 688 without) ancestry.
Article Synopsis
- The study investigates whether ultrasound detection of monosodium urate crystals can predict the development of symptomatic gout in individuals with elevated urate levels over a five-year period.
- It involves more than 250 participants with asymptomatic hyperuricemia, assessing various health metrics and using ultrasound imaging to monitor the presence of MSU crystal deposition.
- The research is ethically approved and aims to share findings through peer-reviewed publications and conferences.
Article Synopsis
- A study found that an AI-driven gout management system (GIMS) led to a lower incidence of stage ≥3 chronic kidney disease (CKD) compared to a standard medical records system.
- Participants using GIMS had a better rate of achieving target serum urate levels (<6.0 mg/dl) compared to those in the standard system.
- The findings suggest that using AI in managing gout may enhance kidney health and treatment effectiveness.
Article Synopsis
- * The study analyzed data from 258 gout patients and found that increased oxypurinol exposure is necessary for effective urate reduction in those with decreased kidney function or on diuretics, despite lower overall dose requirements at severe kidney impairment.
- * Ultimately, the research concluded that patients with significant kidney impairment need lower allopurinol doses, but these doses do not directly correlate with kidney function, and diuretics do not affect required doses.
Article Synopsis
- Patients' perceptions of their illnesses can significantly affect their health outcomes, and traditional measures to assess these beliefs can be cumbersome.
- A study involving 323 patients with various rheumatic diseases in New Zealand utilized word clouds to visually represent their experiences and analyzed them for common themes.
- The results indicated that while the most frequent themes were related to symptoms and emotions, variations existed among conditions, highlighting unique experiences such as social impacts in gout and burdens in ankylosing spondylitis.
Article Synopsis
- - Gout is a chronic condition caused by the immune system's reaction to monosodium urate crystals due to high uric acid levels, and recent research sheds light on its inflammatory mechanisms.
- - A large genome-wide association study (GWAS) involving 2.6 million people identified 377 genetic locations linked to gout, with a focus on 149 new loci related to urate and gout inflammation.
- - The study also pinpointed candidate genes influencing the inflammatory response in gout, including those affecting NLRP3 inflammasome activity, and suggests a potential causal role of specific genetic factors in developing the disease.
Article Synopsis
- This study aimed to develop and validate a dual-energy computed tomography-based radiomics model to differentiate between patients with gout flares and those without, addressing a current research gap.
- It involved analyzing data from 200 patients, including 150 with past gout flares, to extract and evaluate specific radiomic features related to tophi in the foot joints, utilizing advanced statistical methods for model development.
- The comprehensive model, which combined optimal radiomic features and key clinical factors like disease duration and hypertension, showed strong predictive performance, outperforming individual models in clinical relevance and accuracy.
Article Synopsis
- The study aimed to compare two definitions of gout remission in a clinical trial focused on nurse-led care versus usual care.
- Data from a randomized trial with 517 participants showed that nurse-led care significantly improved the odds of achieving remission, particularly when using a simplified definition.
- The simplified remission definition not only identified more participants in remission over time but also correlated with better gout management outcomes, proving to be a valid and practical alternative.
Aims: The essential components of a rheumatology service for public hospital rheumatology services in Aotearoa New Zealand are not yet defined. We aimed to seek the views of users of public hospital rheumatology services on potential components of a rheumatology service.
Methods: Online survey of adults in Aotearoa New Zealand who self-reported as having used district health board rheumatology services in the past 5 years.
Objective: Little is known about the preferences of people with rheumatoid arthritis (RA) regarding tapering of biologic disease-modifying antirheumatic drugs (bDMARDs). The aim of this study was to assess the preferences of people with RA in relation to potential treatment-related benefits and risks of bDMARD tapering and the health care service-related attributes that affect tapering.
Methods: Participants with RA who had experience taking a bDMARD completed an online discrete choice experiment.
Objective: Weight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among individuals who were overweight and obese remains unknown. We investigate the relationship between weight loss rate following treatment with anti-obesity medications and the risk of incident gout and recurrent gout flares among individuals who were overweight or obese.
Methods: Using data from the Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication.
Objectives: Patients with gout need to adhere to medication over time to achieve good outcomes. We assessed self-reported adherence to medication with urate lowering therapy (ULT) 5 years after a treat-to-target intervention and studied how non-adherence was related to baseline demographic and disease variables.
Methods: Patients in the NOR-Gout observational study were included after a recent gout flare and serum urate >360 µmol/L.
Objectives: Use of handheld portable ultrasound is increasing and would improve access for people with rheumatic disease when conventional, cart-based ultrasound is unavailable. This study compared handheld and cart-based ultrasound for the assessment of gout lesions in people with gout.
Methods: The lower limbs of 21 participants with gout were independently scanned at six sites (1st and 2nd metatarsophalangeal joints, knee, patellar ligament, Achilles tendon, and peroneal tendons) using cart-based (LOGIQ P9) and handheld (Vscan Air™) ultrasound by two rheumatologists.
Objectives: The dynamics of monosodium urate (MSU) crystal changes across a range of serum urate concentrations in people with gout are unknown. This study aimed to systematically examine the relationship between serum urate and changes in dual-energy CT (DECT) urate volume in people with gout and stable serum urate concentrations.
Methods: Individual participant data were analysed from three studies of people with gout.
Objective: Previous research has identified that gout impacts various domains of daily life. However, there have been no qualitative studies focusing on employment. This study aimed to understand the impact of gout on employment.
View Article and Find Full Text PDFObjectives: The minor allele of the common rs2231142 ABCG2 variant predicts inadequate response to allopurinol urate lowering therapy. We hypothesize that additional variants in genes encoding urate transporters and allopurinol-to-oxypurinol metabolic enzymes also predict allopurinol response.
Methods: This study included a subset of participants with gout from the Long-term Allopurinol Safety Study Evaluating Outcomes in Gout Patients (LASSO), whose whole genome was sequenced (n = 563).