Hyon Choi

Research Scientist of Rheumatology, MD, DrPH, FRCPC

Appointments

  • Professor of Medicine, Harvard Medical School
  • Director of Clinical Epidemiology in the Division of Rheumatology, Allergy, and Immunology at Massachusetts General Hospital

Research Interests

  • Rheumatic disorders

Dr. Hyon Choi is a Professor of Medicine at Harvard Medical School as well as the Director of Clinical Epidemiology in the Division of Rheumatology, Allergy, and Immunology at Massachusetts General Hospital and a Research Scientist at Arthritis Research Canada.

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).

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In 2005 Dr. Choi left the Harvard Medical School to accept the first Mary Pack Arthritis Society Chair in Rheumatology. 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

Dalbeth N, Bardin T, Doherty M, Lioté F, Richette P, Saag KG, So AK, Stamp LK, Choi HK, Terkeltaub R. Discordant American College of Physicians and international rheumatology guidelines for gout management: consensus statement of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN). Nat Rev Rheumatol. 2017 Epub ahead of print. https://www.ncbi.nlm.nih.gov/pubmed/28794514

 

Oza A, Lu N, Schoenfeld SR, Fisher MC, Dubreuil M, Rai SK, Zhang Y, Choi HK. Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study. Ann Rheum Dis. 2017;August Epub ahead of print. https://www.ncbi.nlm.nih.gov/pubmed/28698231

 

Jutkowitz E, Alarid-Escudero F, Choi HK, Kuntz KM, Jalal H. Prioritizing Future Research on Allopurinol and Febuxostat for the Management of Gout: Value of Information Analysis. Pharmacoeconomics. 2017 Epub ahead of print. https://www.ncbi.nlm.nih.gov/pubmed/28631197

 

Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;9(357)j1794. https://www.ncbi.nlm.nih.gov/pubmed/28487277

 

Sparks JA, Chang SC, Nguyen UDT, Barbhaiya M, Tedeschi SK, Lu B, Costenbader KH, Zhang Y, Choi HK, Karlson EW. Smoking behavior changes in the early rheumatoid arthritis period and risk of mortality during 36 years of prospective follow-up. Arthritis Care & Research.May 2017. Epub ahead of print. https://www.ncbi.nlm.nih.gov/pubmed/28464477

 

Ogdie A, Kay McGill N, Shin DB, Takeshita J, Jon Love T, Noe MH, Chiesa Fuxench ZC, Choi HK, Mehta NN, Gelfand JM. Risk of venous thromboembolism in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a general population-based cohort study. European Heart Journal. May 2017. Epub ahead of print. https://www.ncbi.nlm.nih.gov/pubmed/28444172

 

Tanner C, Boocock J, Stahl EA, Dobbyn A, Mandal AK, Cadzow M, Phipps-Green AJ, Topless RK, Hindmarsh JH, Stamp LK, Dalbeth N, Choi HK, Mount DB, Merriman TR. Population-Specific Resequencing Associates the ATP-Binding Cassette Subfamily C Member 4 Gene With Gout in New Zealand Māori and Pacific Men. Arthritis & Rheumatology. 2017 Jul;69(7)1461-1469 https://www.ncbi.nlm.nih.gov/pubmed/28371506

 

Tang O, Miller ER 3rd, Gelber AC, Choi HK, Appel LJ, Juraschek SP. DASH diet and change in serum uric acid over time. Clin Rheumatol. 2017 Jun;36(6):1413-1417. https://www.ncbi.nlm.nih.gov/pubmed/28361235

 

Aviña-Zubieta JA, Jansz M, Sayre EC, Choi HK. The Risk of Deep Venous Thrombosis and Pulmonary Embolism in Primary Sjögren Syndrome: A General Population-based Study. J Rheumatol. 2017 Aug;44(8):1184-1189. https://www.ncbi.nlm.nih.gov/pubmed/28298559

 

Shiozawa A, Szabo SM, Bolzani A, Cheung A, Choi HK. Serum Uric Acid and the Risk of Incident and Recurrent Gout: A Systematic Review. J Rheumatol. 2017 Mar;44(3):388-39. https://www.ncbi.nlm.nih.gov/pubmed/28148699

 

Fisher MC, Rai SK, Lu N, Zhang Y, Choi HK. The unclosing premature mortality gap in gout: a general population-based study. Ann Rheum Dis. 2017 Jul;76(7):1289-1294. https://www.ncbi.nlm.nih.gov/pubmed/28122760

 

Ogdie A, Harter L, Shin D, Baker J, Takeshita J, Choi HK, Love TJ, Gelfand JM. The risk of fracture among patients with psoriatic arthritis and psoriasis: a population-based study. Ann Rheum Dis. 2017 May;76(5):882-885. https://www.ncbi.nlm.nih.gov/pubmed/28093419

 

Rai SK, Aviña-Zubieta JA, McCormick N, De Vera MA, Shojania K, Sayre EC, Choi HK. The rising prevalence and incidence of gout in British Columbia, Canada: Population-based trends from 2000 to 2012. Semin Arthritis Rheum. 2017 Feb;46(4):451-456. https://www.ncbi.nlm.nih.gov/pubmed/28040245

 

Unizony S, Lu N, Tomasson G, Zhang Y, Merkel PA, Stone JH, Aviña-Zubieta JA, Choi HK. Temporal Trends of Venous Thromboembolism Risk Before and After Diagnosis of Giant Cell Arteritis. Arthritis Rheumatol. 2017 Jan;69(1):176-184. https://www.ncbi.nlm.nih.gov/pubmed/28029234

 

FitzGerald JD, Neogi T, Choi HK. Editorial: Do Not Let Gout Apathy Lead to Gouty Arthropathy. Arthritis Rheumatol. 2017 Mar;69(3):479-482. https://www.ncbi.nlm.nih.gov/pubmed/28002890

 

Juraschek SP, Choi HK, Tang O, Appel LJ, Miller ER 3rd. Opposing effects of sodium intake on uric acid and blood pressure and their causal implication. J Am Soc Hypertens. 2016 Dec;10(12):939-946.e2. https://www.ncbi.nlm.nih.gov/pubmed/27938853

 

Jutkowitz E, Dubreuil M, Lu N, Kuntz KM, Choi HK. The cost-effectiveness of HLA-B*5801 screening to guide initial urate-lowering therapy for gout in the United States. Semin Arthritis Rheum. 2017 Apr;46(5):594-600. https://www.ncbi.nlm.nih.gov/pubmed/27916277

 

Aviña-Zubieta JA, Mai A, Amiri N, Dehghan N, Ann Tan J, Sayre EC, Choi HK. Risk of Myocardial Infarction and Stroke in Patients With Granulomatosis With Polyangiitis (Wegener’s): A Population-Based Study. Arthritis Rheumatol. 2016 Nov;68(11):2752-2759 https://www.ncbi.nlm.nih.gov/pubmed/27213713

 

Wallace ZS, Miloslavsky EM, Cascino M, Unizony SH, Lu N, Hoffman GS, Kallenberg CGM, Langford CA, Merkel PA, Monach PA, Seo P, Spiera R, St Clair EW, Specks U, Brunetta P, Choi HK, Stone JH. Effect of Disease Activity, Glucocorticoid Exposure, and Rituximab on Body Composition During Induction Treatment of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Arthritis Care Res (Hoboken). 2017 Jul;69(7):1004-1010. https://www.ncbi.nlm.nih.gov/pubmed/27696762

 

Paik JM, Kim SC, Feskanich D, Choi HK, Solomon DH, Curhan GC. Gout and Risk of Fracture in Women: A Prospective Cohort Study. Arthritis Rheumatol. 2017 Feb;69(2):422-428 https://www.ncbi.nlm.nih.gov/pubmed/27589491

 

Rai SK, Aviña-Zubieta JA, McCormick N, De Vera MA, Lacaille D, Sayre EC, Choi HK. Trends in Gout and Rheumatoid Arthritis Hospitalizations in Canada From 2000 to 2011. Arthritis Care Res (Hoboken). 2017 May;69(5):758-762. https://www.ncbi.nlm.nih.gov/pubmed/27565008

 

Juraschek SP, Gelber AC, Choi HK, Appel LJ, Miller ER 3rd. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid. Arthritis Rheumatol. 2016 Dec;68(12):3002-3009 https://www.ncbi.nlm.nih.gov/pubmed/27523583

 

Miloslavsky EM, Naden RP, Bijlsma JW, Brogan PA, Brown ES, Brunetta P, Buttgereit F, Choi HK, DiCaire JF, Gelfand JM, Heaney LG, Lightstone L, Lu N, Murrell DF, Petri M, Rosenbaum JT, Saag KS, Urowitz MB, Winthrop KL, Stone JH. Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis. Ann Rheum Dis. 2017 Mar;76(3):543-546 https://www.ncbi.nlm.nih.gov/pubmed/27474764

 

Thorarensen SM, Lu N, Ogdie A, Gelfand JM, Choi HK, Love TJ. Physical trauma recorded in primary care is associated with the onset of psoriatic arthritis among patients with psoriasis. Ann Rheum Dis. 2017 Mar;76(3):521-525 https://www.ncbi.nlm.nih.gov/pubmed/27457510

 

Miloslavsky EM, Lu N, Unizony S, Choi HK, Merkel PA, Seo P, Spiera R, Langford CA, Hoffman GS, Kallenberg CG, St Clair EW, Tchao NK, Fervenza F, Monach PA, Specks U, Stone JH. Myeloperoxidase-Antineutrophil Cytoplasmic Antibody (ANCA)-Positive and ANCA-Negative Patients With Granulomatosis With Polyangiitis (Wegener’s): Distinct Patient Subsets. Arthritis Rheumatol. 2016 Dec;68(12):2945-2952. https://www.ncbi.nlm.nih.gov/pubmed/27428559

 

Robinson PC, Choi HK, Do R, Merriman TR. Insight into rheumatological cause and effect through the use of Mendelian randomization. Nat Rev Rheumatol. 2016 Aug;12(8):486-96 https://www.ncbi.nlm.nih.gov/pubmed/28223712

 

Dalbeth N, Choi HK, Terkeltaub R. Review: Gout: A Roadmap to Approaches for Improving Global Outcomes. Arthritis Rheumatol. 2017 Jan;69(1):22-34. https://www.ncbi.nlm.nih.gov/pubmed/27389665

 

Wallace ZS, Lu N, Miloslavsky E, Unizony S, Stone JH, Choi HK. Nationwide Trends in Hospitalizations and In-Hospital Mortality in Granulomatosis With Polyangiitis (Wegener’s). Arthritis Care Res (Hoboken). 2017 Jun;69(6):915-921. https://www.ncbi.nlm.nih.gov/pubmed/27389595

 

Zhang Y, Lu N, Peloquin C, Dubreuil M, Neogi T, Aviña-Zubieta JA, Rai SK, Choi HK. Improved survival in rheumatoid arthritis: a general population-based cohort study. Ann Rheum Dis. 2017 Feb;76(2):408-413. https://www.ncbi.nlm.nih.gov/pubmed/27338777

 

Nguyen UD, Zhang Y, Louie-Gao Q, Niu J, Felson DT, LaValley MP, Choi HK. Obesity Paradox in Recurrent Attacks of Gout in Observational Studies: Clarification and Remedy. Arthritis Care Res (Hoboken). 2017 Apr;69(4):561-566. https://www.ncbi.nlm.nih.gov/pubmed/27331767

 

Lim SY, Lu N, Oza A, Fisher M, Rai SK, Menendez ME, Choi HK. Trends in Gout and Rheumatoid Arthritis Hospitalizations in the United States, 1993-2011. JAMA. 2016 Jun 7;315(21):2345-7. https://www.ncbi.nlm.nih.gov/pubmed/27272587

 

Lu N, Rai SK, Terkeltaub R, Kim SC, Menendez ME, Choi HK. Racial disparities in the risk of Stevens-Johnson Syndrome and toxic epidermal necrolysis as urate-lowering drug adverse events in the United States. Semin Arthritis Rheum. 2016 Oct;46(2):253-8. https://www.ncbi.nlm.nih.gov/pubmed/27217070

 

Misra D, Lu N, Felson D, Choi HK, Seeger J, Einhorn T, Neogi T, Zhang Y. Does knee replacement surgery for osteoarthritis improve survival? The jury is still out. Ann Rheum Dis. 2017 Jan;76(1):140-146. https://www.ncbi.nlm.nih.gov/pubmed/27190096

 

Jiménez MC, Curhan GC, Choi HK, Forman JP, Rexrode KM. Plasma uric acid concentrations and risk of ischaemic stroke in women. Eur J Neurol. 2016 Jul;23(7):1158-64. https://www.ncbi.nlm.nih.gov/pubmed/27061733

 

Neogi T, Choi HK. Editorial: Pursuit of a Dual-Benefit Antigout Drug: A First Look at Arhalofenate. Arthritis Rheumatol. 2016 Aug;68(8):1793-6. https://www.ncbi.nlm.nih.gov/pubmed/26990165

 

Lee T, Lu N, Felson DT, Choi HK, Dalal DS, Zhang Y, Dubreuil M. Use of non-steroidal anti-inflammatory drugs correlates with the risk of venous thromboembolism in knee osteoarthritis patients: a UK population-based case-control study. Rheumatology (Oxford). 2016 Jun;55(6):1099-105. https://www.ncbi.nlm.nih.gov/pubmed/26983451

 

Zhang Y, Niu J, Choi HK. Excess Mortality among Persons with Type 2 Diabetes. N Engl J Med. 2016 Feb 25;374(8):788. https://www.ncbi.nlm.nih.gov/pubmed/26933855

 

Wallace ZS, Mattoo H, Mahajan VS, Kulikova M, Lu L, Deshpande V, Choi HK, Pillai S, Stone JH. Predictors of disease relapse in IgG4-related disease following rituximab. Rheumatology (Oxford). 2016 Jun;55(6):1000-8. https://www.ncbi.nlm.nih.gov/pubmed/26888853

 

Rasheed H, McKinney C, Stamp LK, Dalbeth N, Topless RK, Day R, Kannangara D, Williams K, Smith M, Janssen M, Jansen TL, Joosten LA, Radstake TR, Riches PL, Tausche AK, Lioté F, Lu L, Stahl EA. The Toll-Like Receptor 4 (TLR4) Variant rs2149356 and Risk of Gout in European and Polynesian Sample Sets. PLoS One. 2016 Jan 25;11(1):e0147939. https://www.ncbi.nlm.nih.gov/pubmed/26808548

 

Dubreuil M, Peloquin C, Zhang Y, Choi HK, Inman RD, Neogi T. Validity of ankylosing spondylitis diagnoses in The Health Improvement Network. Pharmacoepidemiol Drug Saf. 2016 Apr;25(4):399-404. https://www.ncbi.nlm.nih.gov/pubmed/26762622

 

Unizony S, Villarreal M, Miloslavsky EM, Lu N, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CM, St Clair EW, Ikle D, Tchao NK, Ding L, Brunetta P, Choi HK, Monach PA, Fervenza F, Stone JH, Specks U; RAVE-ITN Research Group. Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type. Ann Rheum Dis. 2016 Jun;75(6):1166-9. https://www.ncbi.nlm.nih.gov/pubmed/26621483

 

Aviña-Zubieta JA, Man A, Yurkovich M, Huang K, Sayre EC, Choi HK. Early Cardiovascular Disease After the Diagnosis of Systemic Sclerosis. Am J Med. 2016 Mar;129(3):324-31. https://www.ncbi.nlm.nih.gov/pubmed/26603342

 

Zhang Y, Peloquin CE, Dubreuil M, Roddy E, Lu N, Neogi T, Choi HK. Sleep Apnea and the Risk of Incident Gout: A Population-Based, Body Mass Index-Matched Cohort Study. Arthritis Rheumatol. 2015 Dec;67(12):3298-302 https://www.ncbi.nlm.nih.gov/pubmed/26477891

 

Rai SK, Choi HK, Sayre EC, Aviña-Zubieta JA. Risk of myocardial infarction and ischaemic stroke in adults with polymyositis and dermatomyositis: a general population-based study. Rheumatology (Oxford). 2016 Mar;55(3):461-9. https://www.ncbi.nlm.nih.gov/pubmed/26424835

 

Aviña-Zubieta JA, Vostretsova K, De Vera MA, Sayre EC, Choi HK. The risk of pulmonary embolism and deep venous thrombosis in systemic lupus erythematosus: A general population-based study. Semin Arthritis Rheum. 2015 Oct;45(2):195-201. https://www.ncbi.nlm.nih.gov/pubmed/26364556

 

Lu N, Misra D, Neogi T, Choi HK, Zhang Y. Total joint arthroplasty and the risk of myocardial infarction: a general population, propensity score-matched cohort study. Arthritis Rheumatol. 2015 Oct;67(10):2771-9. https://www.ncbi.nlm.nih.gov/pubmed/26331443

 

Wallace ZS, Lu N, Unizony S, Stone JH, Choi HK. Improved survival in granulomatosis with polyangiitis: A general population-based study. Semin Arthritis Rheum. 2016 Feb;45(4):483-9. https://www.ncbi.nlm.nih.gov/pubmed/26323883

 

Lee SH, Byrne EM, Hultman CM, Kähler A, Vinkhuyzen AA, Ripke S, Andreassen OA, Frisell T, Gusev A, Hu X, Karlsson R, Mantzioris VX, McGrath JJ, Mehta D, Stahl EA, Zhao Q, Kendler KS, Sullivan PF, Price AL, O’Donovan M, Okada Y, Mowry BJ, Raychaudhuri S, Wray NR; Schizophrenia Working Group of the Psychiatric Genomics Consortium and Rheumatoid Arthritis Consortium International; Schizophrenia Working Group of the Psychiatric Genomics Consortium Authors, Choi HK et al.  New data and an old puzzle: the negative association between schizophrenia and rheumatoid arthritis. Int J Epidemiol. 2015 Oct;44(5):1706-21. https://www.ncbi.nlm.nih.gov/pubmed/26286434

 

Amiri N, De Vera M, Choi HK, Sayre EC, Avina-Zubieta JA. Increased risk of cardiovascular disease in giant cell arteritis: a general population-based study. Rheumatology (Oxford). 2016 Jan;55(1):33-40. https://www.ncbi.nlm.nih.gov/pubmed/26248811

 

Schoenfeld SR, Lu L, Rai SK, Seeger JD, Zhang Y, Choi HK. Statin use and mortality in rheumatoid arthritis: a general population-based cohort study. Ann Rheum Dis. 2016 Jul;75(7):1315-20. https://www.ncbi.nlm.nih.gov/pubmed/26245753