Hyon Choi

Title and Accreditations

Senior Research Scientist, Rheumatology, MD, DrPH, FRCPC

Appointments

Professor of Medicine, Harvard Medical School
Adjunct Professor of Medicine, University of British Columbia
Director, Gout and Crystal Arthropathy Center, Department of Medicine, Massachusetts General Hospital
Director, Clinical Epidemiology and Health Outcomes, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital

Biography

Dr. Hyon Choi is a Professor of Medicine at Harvard Medical School as well as the Director of Clinical Epidemiology and Health Outcomes Research in the Division of Rheumatology, Allergy, and Immunology at Massachusetts General Hospital and a Senior 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). However, his primary interest is in gout and other crystal arthropathies, and he has more than two decades’ experience (with > 200 peer-reviewed publications) investigating the prevalence and incidence of gout as well as its cardio-kidney-metabolic comorbidity burden, persistent premature mortality, and comparative effectiveness of treatments.

Dr. Choi’s 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, where strikingly 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).

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.

Her research focuses on two areas: 1) Studying the impact of arthritis on employment and preventing work disability. To that effect, she has developed Making-it-WorkTM , an online program helping people with arthritis deal with employment issues. 2) Evaluating the quality of health care services received by people with RA and conducting pharmaco-epidemiology studies, using BC administrative health data. Her research has been supported by peer reviewed grants from the Canadian Institutes of Health Research, the Canadian Arthritis Network, The Arthritis Society of Canada and the Canadian Rheumatology Association.

She holds peer-reviewed operating grants for her research from CIHR. She has published her research in Arthritis and Rheumatism, Annals of Rheumatic Diseases, Arthritis Care and Research, Journal of Rheumatology, Journal of Vocational Rehabilitation, Canadian Medical Association Journal, Human Immunology, Health Policy, Lancet, and Journal of Clinical Epidemiology.

She has received distinction awards for her contribution to rheumatology research, including the Jeff Shiroky Award for excellence in rheumatoid arthritis research, the Young Investigator Award from the Canadian Rheumatology Association and the Quality of Life Research Award from the Institute of Musculoskeletal Health and Arthritis (IMHA)—a distinction award for having obtained the highest score of all applications in Arthritis, Pain and Disability. Finally, she was a recipient of the Martin M. Hoffman Award for Excellence in Research at the University of British Columbia and in 2013, she was awarded the Queen Elizabeth II Diamond Jubilee Award for her research contributions.

Building on her research on employment and arthritis, she has developed the first comprehensive program specifically designed to prevent Work Disability (WD) in employed people with inflammatory arthritis, such as RA. The program enhances self-management of problems encountered at work due to arthritis and modifies risk factors for WD. The program was pilot tested and showed promising results. It resulted in concrete changes and improved self-confidence and self-rated productivity at work. Her team has converted this program into a web-based version, in order to make this valuable resource more accessible to people with RA all over the province. She has received CIHR funding to test the program’s effectiveness at reducing WD and improving at work productivity in a randomized controlled trial. By preventing WD, this research will reduce the tremendous economic and social burden of RA.

As part of her research evaluating the quality of care for RA at the population level, she has assembled a population-based cohort of RA patients in BC. This research has exposed important gaps in care for RA. She found that the majority of RA patients do not receive the care that is recommended for their disease. More than half are not using the medications considered essential for RA (DMARDs) and few are followed by rheumatologists. These results point to the need for educating family physicians and people with RA about the shift in treatment paradigms in RA, and to the need for increased rheumatologist access and manpower. She is now evaluating the impact of educational interventions, such as academic detailing to Family Physicians, on the quality of care delivered to people with rheumatoid arthritis.

She is also evaluating the effect of medications used to treat RA on cardiovascular disease. Her research has been looking at other chronic medical conditions that people with RA are at risk of, such as cardiovascular diseases, infections and osteoporosis, and evaluating how these are treated and how medications used for RA may impact these conditions.

This research is important to people with RA and their health care providers, and has potential to improve the quality of care and outcome of RA.

Research Changes Real Lives

Behind every study is a person. Meet some Canadians whose lives are moving forward thanks to arthritis research.

Vianne

Ankylosing Spondylitis

Living with Arthritis: Vianne’s Story

Arthritis Is Ageless, Vianne’s story

Read Vianne’s Story
Ty’s story

Ty

Ankylosing Spondylitis

Living with Arthritis: Ty’s story

A Run to “Make Arthritis Famous”

Read Ty’s Story
Trish’s Story

Trish

Osteoarthritis

Living with Arthritis: Trish’s Story

From a young age, I always loved participating in sports, especially downhill skiing and playing badminton. But what people don’t think about is there are often injuries in youth sports that result in life changing health conditions. For me this meant by the time that I was 22 years of age, I required ACL surgery on my knee.
Read Trish’s Story
Tamara’s Story

Tamara

Rheumatoid Arthritis

Living with Arthritis: Tamara’s Story

Making a Difference, Tamara’s story

Read Tamara’s Story
Steve’s Story

Steve

Rheumatoid Arthritis

Living with Arthritis: Steve’s Story

Arthritis Changed Everything 

I was diagnosed with rheumatoid arthritis at 25. The symptoms came on quickly. I was shocked that someone my age could have this disease. Four years later, I found myself bussing to the emergency room for what I thought were minor chest pains. In reality, I was in heart failure at 29. By the time I reached the hospital, one of the valves in my heart had almost stopped working.
Read Steve’s Story
Nikki’s Story

Nikki

Rheumatoid Arthritis

Living with Arthritis: Nikki’s Story

I was 19 years old when I was diagnosed with rheumatoid arthritis. I had zero understanding of the disease. I didn’t know anyone with arthritis and I thought it only affected the elderly. I didn’t even want to tell people around me that I had arthritis. I didn’t want to feel like a burden. So initially, I hid my disease – just trying to battle it, while keeping it to myself.
Read Nikki’s Story
Natasha’s Story

Natasha

Juvenile Idiopathic Arthritis

Living with Arthritis: Natasha’s Story

ARTHRITIS RESEARCH IN ACTION

I was 13-years-old when I was diagnosed with juvenile idiopathic arthritis (JIA). I didn’t know what it was. My grandmother had arthritis, but I was young and healthy. How could I have an incurable disease? It didn’t make sense.
Read Natasha’s Story
Lisa’s Story

Lisa

Rheumatoid Arthritis

Living with Arthritis: Lisa’s Story

ARTHRITIS CHANGED EVERYTHING

I was diagnosed with rheumatoid arthritis on my daughter’s sixth birthday. At the time, I was 37. After years of pain and worsening unexplained symptoms, I felt relieved to finally have answers. But that relief quickly changed to concern. As a physiotherapist, I was confident about treatment options and getting my disease under control. Yet, I underestimated the impact arthritis would have on my life.
Read Lisa’s Story
Kelly Barber’s Story

Kelly Barber

Osteoarthritis

Living with Arthritis: Kelly Barber’s Story

Osteoarthritis in his 40’s: Firefighter Kelly Barber Tells His Story

Read Kelly Barber’s Story
Jacob’s Story

Jacob

Ankylosing Spondylitis

Living with Arthritis: Jacob’s Story

Jacob was the picture of health. Until he wasn’t.

Read Jacob’s Story