Hmong patients in Minnesota are suffering from gout and gout-related co-morbidities more than other patients in Minnesota. Hmong are four times as likely to develop gout. They have worse disease symptoms and complications—more tophi and joint destruction; uric acid kidney stones; massive kidney stones; and procedures for stones, including operations to remove their kidneys. In addition, Hmong gout sufferers report that usual gout medicines are ineffective. Our preliminary data identified that Hmong have a higher frequency of a genetic variation that has been associated with high rates of hyperuricemia and may also influence response to gout medicines.
We formed the Hmong Gout Genomics Board, which comprises Hmong people with gout, Hmong healthcare professionals, West Side Community Health Services physicians, SoLaHmo Partnership for Health and Wellness community researchers, and University of Minnesota pharmacists. This community-physician-academic partnership seeks to identify explanations for this disparity in clinical incidence by exploring the potential relationship between apparent genetic differences with response to medicines and gout co-morbidities. Our ultimate goal is to identify more effective therapies for this unique population at risk of gout complications.
Through the Pipeline to Proposal process, we will build on current working relationships; gain input from Hmong community members about the results of current research (GOUT-H clinicaltrial.gov NCT02371421); identify new research partners; and train the team, including Hmong professionals and community members, in community-effectiveness research. We plan to ultimately conduct a community-engaged comparative effectiveness project to identify effective therapies to reduce the suffering of Hmong people with gout complications.