Nicola Dalbeth

Last updated

Nicola Dalbeth
NationalityNew Zealander
Alma mater University of Otago
Scientific career
FieldsResearch into diagnosis and management gout
Institutions University of Auckland

Nicola DalbethFRSNZ is a New Zealand academic rheumatologist whose research focuses on understanding the impact and mechanisms of gout. She supports clinical and laboratory research programmes and holds dual appointments as a full professor at the University of Auckland and as a consultant for the Auckland District Health Board.

Contents

Education and career

Dalbeth completed undergraduate medical training at Otago Medical School in 1995 and rheumatology advanced training in Auckland in 2002. After postgraduate research training at the University of Oxford and Imperial College London, Dalbeth returned to Auckland in 2005 and to take up dual appointments as professor at the University of Auckland and at Auckland District Health Board. [1] [2] In 2016, she was chair of The Health & Safety Commission's expert advisory group on gout. [3]

Dalbeth is a principal investigator in the Auckland Bone and Joint Research Group, [4] and a member of the medical committee for the Auckland Medical Research Foundation. [5] She is co-chair of the Calcium pyrophosphate deposition (CPPD) Working Group, (OMERACT), [6] [7] and was part of the Core Leadership Team for 2020 American College of Rheumatology Guideline for the Management of Gout. [8] Dalbeth is an Associate Investigator at the Maurice Wilkins Centre for Molecular Biodiscovery, [9] and a Consultant for Auckland District Health Board Rheumatology Services. [10]

Selected research

Much of Dalbeth's research that focuses on gout challenges widely-held beliefs about the risk factors and causes of the condition. Her work confirms that there are many factors determining gout, but concludes that most people, including some health professionals, view it as a "self-inflicted condition for which dietary solutions are most important and effective, despite no clinical trial data in people with gout to support this approach." [11]

In 2021 in response to data that showed gout disproportionally affects Māori, Dalbeth co-authored a research paper that reviewed inequities in health due to gout management. The paper concluded:

That there are disparities in gout care in Indigenous people is without a doubt. The challenge for healthcare providers in every country, including Aotearoa New Zealand, is to authentically partner with Indigenous people to develop culturally appropriate, acceptable and effective systems to overcome disparities and enable a pathway to health equity and beyond for people with gout. To fail to do so is acceptance of the status quo, and is, by definition, structural racism. [12]

A review of the effectiveness of interventions to improve uptake of urate-lowering therapy (URL) in patients with gout in 2020 noted, in the paper co-edited by Dalbeth, that globally low numbers of patients were being treated with ULT was low. The researchers concluded for this to improve there needed to be a greater patient understanding of the process to get adherence to the therapy, and that nurse-led interventions were often the most effective, [suggesting that this] may be because they involve the most patient engagement, empowering patients to share decisions about their care, which increases the likelihood that they will make the sustained behavioural changes required to take long-term medication." [13]

A paper published in 2021 summarising research that Dalbeth had been involved in, concluded that there was the existence of population-amplified genetic variants conferring risk of gout in Polynesian populations. [14] Dalbeth collaborated on a 2020 study that did a content analysis of visual images used in educational resources about Gout and from the data, the researchers concluded: "Key concepts about gout and treatment are underrepresented in the images used in educational resources for patients. A large proportion of the images do not convey useful information about gout or its management." [15]

Awards and honours

Dalbeth was elected a Fellow of the Royal Society of New Zealand in 2019, an "honour that recognises distinction in research, scholarship or the advancement of knowledge at the highest international standards." [16]

In 2021 Dalbeth won the top research award of the medical faculty of the University of Auckland, the Gluckman Medal, for distinguished contribution to research on gout. Professor John Fraser, the Dean of the Faculty of Medical and Health Science said "[that] Nicola's research has contributed to dispelling the many myths about gout and her findings have been instrumental in improving the treatments available for patients with this debilitating disease." [17]

Publications

Related Research Articles

<span class="mw-page-title-main">Arthritis</span> Type of joint disorder

Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types of arthritis, other organs are also affected. Onset can be gradual or sudden.

<span class="mw-page-title-main">Rheumatoid arthritis</span> Type of autoimmune arthritis

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves and blood. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months.

<span class="mw-page-title-main">Uric acid</span> Organic compound

Uric acid is a heterocyclic compound of carbon, nitrogen, oxygen, and hydrogen with the formula C5H4N4O3. It forms ions and salts known as urates and acid urates, such as ammonium acid urate. Uric acid is a product of the metabolic breakdown of purine nucleotides, and it is a normal component of urine. High blood concentrations of uric acid can lead to gout and are associated with other medical conditions, including diabetes and the formation of ammonium acid urate kidney stones.

<span class="mw-page-title-main">Gout</span> Form of arthritis causing swollen joints

Gout is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint, caused by the deposition of needle-like crystals of uric acid known as monosodium urate crystals. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected (Podagra) in about half of cases. It may also result in tophi, kidney stones, or kidney damage.

Rheumatology is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome. Doctors who have undergone formal training in rheumatology are called rheumatologists.

<span class="mw-page-title-main">Allopurinol</span> Medication

Allopurinol is a medication used to decrease high blood uric acid levels. It is specifically used to prevent gout, prevent specific types of kidney stones and for the high uric acid levels that can occur with chemotherapy. It is taken orally or intravenously.

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Fibromyalgia is a medical condition defined by the presence of chronic widespread pain, fatigue, waking unrefreshed, cognitive symptoms, lower abdominal pain or cramps, and depression. Other symptoms include insomnia and a general hypersensitivity.

<span class="mw-page-title-main">Hyperuricemia</span> Medical condition

Hyperuricaemia or hyperuricemia is an abnormally high level of uric acid in the blood. In the pH conditions of body fluid, uric acid exists largely as urate, the ion form. Serum uric acid concentrations greater than 6 mg/dL for females, 7 mg/dL for men, and 5.5 mg/dL for youth are defined as hyperuricemia. The amount of urate in the body depends on the balance between the amount of purines eaten in food, the amount of urate synthesised within the body, and the amount of urate that is excreted in urine or through the gastrointestinal tract. Hyperuricemia may be the result of increased production of uric acid, decreased excretion of uric acid, or both increased production and reduced excretion.

<span class="mw-page-title-main">Osteoarthritis</span> Form of arthritis caused by degeneration of joints

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Rheumatism or rheumatic disorders are conditions causing chronic, often intermittent pain affecting the joints or connective tissue. Rheumatism does not designate any specific disorder, but covers at least 200 different conditions, including arthritis and "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism". There is a close overlap between the term soft tissue disorder and rheumatism. Sometimes the term "soft tissue rheumatic disorders" is used to describe these conditions.

<span class="mw-page-title-main">Juvenile idiopathic arthritis</span> Childhood rheumatic disease

Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis (JRA), is the most common chronic rheumatic disease of childhood, affecting approximately 3.8 to 400 out of 100,000 children. Juvenile, in this context, refers to disease onset before 16 years of age, while idiopathic refers to a condition with no defined cause, and arthritis is inflammation within the joint.

<span class="mw-page-title-main">Tophus</span> Medical condition

A tophus is a deposit of monosodium urate crystals, in people with longstanding high levels of uric acid (urate) in the blood, a condition known as hyperuricemia. Tophi are pathognomonic for the disease gout. Most people with tophi have had previous attacks of acute arthritis, eventually leading to the formation of tophi. Chronic tophaceous gout is known as Harrison Syndrome.

<span class="mw-page-title-main">Fenofibrate</span> Drug of the fibrate class, mainly used to reduce cholesterol levels

Fenofibrate, is an oral medication of the fibrate class used to treat abnormal blood lipid levels. It is less commonly used compared than statins because it treats a different type of cholesterol abnormality to statins. While statins have strong evidence for reducing heart disease and death, there is evidence to suggest that fenofibrate also reduces the risk of heart disease and death. However, this seems only to apply to specific populations of people with elevated triglyceride levels and reduced high-density lipoprotein (HDL) cholesterol. Its use is recommended together with dietary changes.

<span class="mw-page-title-main">Febuxostat</span> Chemical compound

Febuxostat, sold under the brand names Uloric and Adenuric among others, is a medication used long-term to treat gout due to high uric acid levels. It is generally recommended only for people who cannot take allopurinol. When initially started, medications such as NSAIDs are often recommended to prevent gout flares. It is taken by mouth.

<span class="mw-page-title-main">Benzbromarone</span> Chemical compound

Benzbromarone is a uricosuric agent and non-competitive inhibitor of xanthine oxidase used in the treatment of gout, especially when allopurinol, a first-line treatment, fails or produces intolerable adverse effects. It is structurally related to the antiarrhythmic amiodarone.

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Crystal arthropathy is a class of joint disorder that is characterized by accumulation of tiny crystals in one or more joints. Polarizing microscopy and application of other crystallographic techniques have improved identification of different microcrystals including monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite, and calcium oxalate.

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References

  1. ↑ "Professor Nicola Dalbeth, MBChB, MD, FRACP". Gout Study Group. 2018. Archived from the original on 7 April 2022. Retrieved 8 April 2022.
  2. ↑ "Dr Nicola Dalbeth Healthpoint". www.healthpoint.co.nz. Archived from the original on 12 July 2021. Retrieved 8 April 2022.
  3. ↑ "Men, Māori and Pacific people need better gout medication". Hutt Valley DHB. 29 January 2016. Archived from the original on 8 April 2022. Retrieved 8 April 2022.
  4. ↑ Faculty of Medical and Health Sciences. "Bone and Joint Research Group". The University of Auckland. Archived from the original on 4 February 2022. Retrieved 8 April 2022.
  5. ↑ "Our Medical Committee". Auckland Medical Research Foundation. 2020. Archived from the original on 8 April 2022. Retrieved 8 April 2022.
  6. ↑ Working groups. "About the Calcium pyrophosphate deposition (CPPD) Working Group". OMERACT. Archived from the original on 13 July 2021. Retrieved 8 April 2022.
  7. ↑ Tugwell, Peter; et al. (26 November 2007). "OMERACT: An international initiative to improve outcome measurement in rheumatology". Trials. 8 (38): 38. doi: 10.1186/1745-6215-8-38 . PMC   2169260 . PMID   18039364.
  8. ↑ 2020 American College of Rheumatology Guideline for the Management of Gout (Supplementary Appendix 2: Panel/Teams Involved). 2020. Archived (PDF) from the original on 14 July 2021. Retrieved 8 April 2022.
  9. ↑ "Our People: Associate Investigators". Maurice Wilkins Centre. Archived from the original on 13 July 2021. Retrieved 8 April 2022.
  10. ↑ "Auckland DHB Rheumatology Services". adhb. Auckland District Health Board Te Toka Tumai. Archived from the original on 6 March 2022. Retrieved 8 April 2022.
  11. ↑ "Nicola Dalbeth and Keith J Petrie: It's time to change the name of gout - The BMJ". 5 February 2018. Archived from the original on 12 July 2021. Retrieved 8 April 2022.
  12. ↑ Te Karu, Leanne; Dalbeth, Nicoloa; Stamp, Lisa K. (30 June 2021). "Inequities in people with gout: a focus on Māori (Indigenous People) of Aotearoa New Zealand". Therapeutic Advances in Musculoskeletal Disease. 13: 1759720X2110280. doi:10.1177/1759720X211028007. PMC   8252336 . PMID   34262623.
  13. ↑ Gill, Iqbal; Dalbeth, Nicola; 'Ofanoa, Malakai; Goodyear-Smith, Felicity (7 July 2020). "Interventions to improve uptake of urate-lowering therapy in patients with gout: a systematic review". BJGP Open. Royal College of General Practitioners. 4 (3): bjgpopen20X101051. doi:10.3399/bjgpopen20x101051. ISSN   2398-3795. PMC   7465587 . PMID   32636201. Archived from the original on 18 March 2022. Retrieved 8 April 2022.
  14. ↑ Ji, Aichang; et al. (1 July 2021). "Aotearoa New Zealand Māori and Pacific population-specific gout risk variants: CLNK is a separate risk gene at the SLC2A9 locus". The Journal of Rheumatology. 48 (1). doi:10.3899/jrheum.201684. S2CID   235711900. Archived from the original on 14 July 2021. Retrieved 13 July 2021.
  15. ↑ Krasnoryadtseva, Alina; Derksen, Christina; Dalbeth, Nicola; Petrie, Keith J. (1 December 2020). "Not Every Picture Tells a Story: A Content Analysis of Visual Images in Patient Educational Resources About Gout". The Journal of Rheumatology. 47 (12): 1815–1821. doi:10.3899/jrheum.191245. PMID   32173653. S2CID   212730804. Archived from the original on 28 December 2019. Retrieved 8 April 2022.
  16. ↑ "Researchers and scholars at the top of their fields elected as Fellows". Royal Society Te Apārangi. 21 November 2019. Archived from the original on 28 December 2019. Retrieved 8 April 2022.
  17. ↑ Health and medicine, Faculty of Medical and Health Sciences (27 April 2021). "World-leading gout expert Professor Nicola Dalbeth wins Gluckman Medal". The University of Auckland. Archived from the original on 28 April 2021. Retrieved 13 July 2021.
  18. 1 2 Khanna, Dinesh; Fitzgerald, John D.; et al. (28 September 2012). "2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia". Arthritis Care & Research. Wiley. 64 (10): 1431–1446. doi:10.1002/acr.21772. ISSN   2151-464X. PMC   3683400 . PMID   23024028.
  19. 1 2 Khanna, Dinesh; Khanna, Puja P.; et al. (28 September 2012). "2012 American College of Rheumatology guidelines for management of gout. Part 2: Therapy and antiinflammatory prophylaxis of acute gouty arthritis" (PDF). Arthritis Care & Research. Wiley. 64 (10): 1447–1461. doi:10.1002/acr.21773. ISSN   2151-464X. PMC   3662546 . PMID   23024029. Archived (PDF) from the original on 28 March 2016.
  20. ↑ Neogi, Tuhina; Jansen, Tim L Th A; Dalbeth, Nicola; et al. (9 September 2015). "2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative" (PDF). Annals of the Rheumatic Diseases. BMJ. 74 (10): 1789–1798. doi:10.1136/annrheumdis-2015-208237. ISSN   0003-4967. PMC   4602275 . PMID   26359487. Archived (PDF) from the original on 6 July 2017.
  21. 1 2 Dalbeth, Nicola; et al. (4 November 2004). "CD56brightNK Cells Are Enriched at Inflammatory Sites and Can Engage with Monocytes in a Reciprocal Program of Activation". The Journal of Immunology. The American Association of Immunologists. 173 (10): 6418–6426. doi: 10.4049/jimmunol.173.10.6418 . ISSN   0022-1767. PMID   15528382. S2CID   26744867. Archived from the original on 26 May 2021.
  22. 1 2 Dalbeth, Nicola; et al. (2006). "Dose Adjustment of Allopurinol According to Creatinine Clearance Does not Provide Adequate Control of Hyperuricemia in Patients with GoutD" (PDF). The Journal of Rheumatology. 33. Archived (PDF) from the original on 8 April 2022.
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