choi

Research Scientist, Rheumatology
MD, DrPH, FRCPC

Appointments
Professor of Medicine, Boston University

Dr. Hyon K. Choi is a board-certified Rheumatologist with a practice located at the Mary Pack Arthritis Centre and the Vancouver General Hospital.   In 2005 Dr. Choi left the Harvard Medical School to accept the first Mary Pack Arthritis Society Chair in Rheumatology.

Dr. Choi’s research interests lie in core issues of rheumatic disorders ranging from common inflammatory arthritis (e.g. gout, rheumatoid arthritis, and psoriatic arthritis) to rare but serious inflammatory conditions (e.g. systemic vasculitis).

His recent work on gout has attracted widespread scientific and public interest. Gout is a common inflammatory arthritis frequently resulting in substantial disability, occupational limitations, and extensive utilization of medical services. However, scientific data on the causes and risk factors for gout (i.e. key data for prevention and management of the condition) remained limited.  Dr. Choi’s recent research has clarified important risk factors of gout based on large prospective cohorts (like individuals differing in specific characteristics): the Health Professionals Follow-up Study (51,529 men) and Nurses’ Health Study (121,700 women). Some of these data have recently been published in top medical journals including the New England Journal of Medicine (4), Lancet (5), and Archives of Internal Medicine (3). Dr. Richard Johnson stated in the accompanying perspective article in the New England Journal of Medicine that “The study thus provides scientific verification of the long-standing view that gout is most common among people whose diet is rich in meats and low in dairy products”.

Dr. Choi also led a large population study on the survival benefit of methotrexate in rheumatoid arthritis, a prototypic chronic progressive inflammatory disorder associated with substantial morbidity and premature death (8). Although methotrexate has been the most frequent choice of antirheumatic therapy for RA over the last two decades, its effect on mortality remained unknown. Using state-of-the-art epidemiologic methods, Dr. Choi’s study found that methotrexate provided a significant survival benefit, largely by reducing cardiovascular death. These findings are directly relevant and important to many patients with rheumatoid arthritis and rheumatologists treating them. Further, the elevated risk of cardiovascular disease in patients with RA and the emerging consensus that chronic inflammation plays a major role in cardiovascular disease has put this work at the front line of several exciting medical fields. The importance of this work with an urgent need for early dissemination was recognized by the Lancet, where the work was published through its fast track publication process.

Furthermore, Dr. Choi’s work extends to the fields of medical decision-making, health policy and management, wherestrikingly increasing medical care costs have become one of the most difficult budgetary issues facing many countries. One of his papers on the cost-effectiveness of biologic therapy in rheumatoid arthritis was acknowledged by the British NHS database for Reviews and Dissemination (9). Furthermore his work on Cox-2 inhibitors (6) outlined a computer model prediction that closely aligned with Merck sand Pfizer’s recent trial results that led to the voluntary withdrawal of their widely used Cox-2 inhibitors (Vioxx and Bextra).

Dr. Choi is an associate professor of Medicine and of Health Care and Epidemiology at the University of British Columbia.  He received master’s and doctorate degrees in epidemiology from Harvard University and rheumatology fellowship training at the Harvard Medical School and Massachusetts General Hospital where Dr. Choi had served as the director of Outcomes Research in the Rheumatology Unit.

During his career Dr. Choi has contributed to his profession by reviewing for the National Institutes of Health and for editorial boards of major medical journals such as the New England Journal of Medicine, Journal of the American Medical Association, Lancet, and Arthritis & Rheumatism.  His contribution to the scientific literature, both as an author and co-author, includes more than 100 publications and he has been an invited speaker at conferences around the world.


Publications

1. Choi HK, MountDB, Reginato A.  Pathogenesis of Gout. Ann Intern Med 2005;143(7):499-516

2. Choi HK, Liu S, Curhan G. Intake of Purine-Rich Foods, Protein, Dairy Product, and Serum Uric Acid Level – The Third National Health and Nutritional Examination Survey Arthritis Rheum 2005 52:283-9.

3. Choi HK, Atkinson K, Karlson E, Curhan G.  Obesity, weight change, hypertension, diuretic use, and risk of gout in men – the health professionals follow-up study. Arch Intern Med 2005 ; 165: 1-7.

4. Choi HK, Atkinson K, Karlson E, Willett W, Curhan G.  Purine-rich foods, dairy intake, and protein intake, and risk of gout in men.  New Eng J Med 2004; 345: 981-986.

5. Choi HK, Atkinson K, Karlson E, Willett W, Curhan G.  Alcohol intake and risk of incident gout in men – a prospective study.  Lancet 2004; 363: 1277-1281

6. Choi HK, Seeger J, Kuntz K. Effects of rofecoxib and naproxen on life expectancy among patients with rheumatoid arthritis: a decision analysis.  Am J Med 2004; 116: 621-629.

7. Wolfe F, Michaud K, Gefeller O, Choi HK. Predicting mortality in patients with rheumatoid arthritis.  Arthritis Rheum 2003; 48: 1530-1542.

8. Choi HK, Hernan M, Seeger J, Robins J, Wolfe F. Methotrexate therapy and mortality in patients with rheumatoid arthritis.  Lancet 2002; 359: 1173-1177.

9. Choi HK, Seeger J, Kuntz K. A cost effectiveness analysis of treatment options for patients with methotrexate-resistant rheumatoid arthritis.  Arthritis Rheum 2000; 43: 2316-2327.