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Professor Nigel Arden MBBS, MRCP, MSc, MD, CCST, FRCP

Professor in Rheumatic Diseases

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Professor Nigel Arden is Professor in Rheumatic Diseases within Medicine at the University of Southampton.

Professor Arden trained at St Thomas’s Hospital, London, where he also completed four years of research into the genetics of osteoporosis. During this time, he gained an MSc in Epidemiology and an MD. He moved to the South Coast in 1996 and in 1998 spent six months as Visiting Assistant Professor in Epidemiology at the University of San Francisco.

In 2000 he commenced his post as Senior Lecturer in Rheumatology and Honorary Consultant Rheumatologist at Southampton University NHS Trust. In 2008, he became a Professor in Rheumatic Diseases at Southampton University and also commenced an appointment with the University of Oxford to develop a joint research department between the two universities of Oxford and Southampton. He is based jointly at the Medical Research Council Epidemiology Resource Centre, Southampton and the Botnar Research Centre, Oxford; where he continues his research into osteoarthritis and osteoporosis.

His clinical interests include all aspects of the rheumatic diseases; however he has special interests in osteoporosis, with particular emphasis on bone disease in patients with cystic fibrosis and inflammatory bowel disease. He additionally has a strong interest in the management of patients with osteoarthritis.


MBBS, University of London (1986)
MRCP, Royal College of Physicians, London (1989)
MSc, Epidemiology, University of London (1995)
MD, University of London (1998)
CCST, Rheumatology, London (2000)
FRCP, Royal College of Physicians, London (2008)

Appointments held

Reader in Musculoskeletal Sciences and Consultant Rheumatologist,
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford

Professor in Rheumatic Diseases and Consultant Rheumatologist,
University of Southampton, Southampton University Hospitals NHS Trust

Research interests

Advanced study and research

Research interests focus on the epidemiology of osteoarthritis and osteoporosis. Based in the Botnar Research Centre with additional sessions at the MRC Lifecourse Epidemiology Unit at the University of Southampton. The programme has several major strands: (a) the intrauterine and genetic origins of osteoarthritis, osteoporosis and vitamin D metabolism; (b) the descriptive epidemiology of osteoarthritis and lower limb arthroplasty and (c) clinical trials in the management of common musculoskeletal conditions.

Expanding research programmes are based around: (a) the complex genetic and environmental influences on osteoarthritis and more importantly their interaction (in collaboration with UCSF and the University of Oxford): (b) the epidemiology of knee and hip osteoarthritis; (c) the epidemiology and survival of total joint replacements in osteoarthritis: (d) the role of bone in the pathogenesis of osteoarthritis; (e) translational research in the form of a number of clinical trials in osteoarthritis.

Further plans to clarify the risk factors for the incidence and progression of osteoarthritis, both radiographic and symptomatic, using a collection of large cohort studies. This work is funded by a large NIHR Biomedical Research Centre grant.

A rapidly developing area of research is the epidemiology of joint arthroplasty. An NIHR Programme grant has been awarded aiming to accurately define the predictors of a successful arthroplasty and its cost effectiveness. It will also produce an accurate and comprehensive risk prediction model for the success of joint arthroplasty.

The programme exploring the association between bone and osteoarthritis has two specific components: a) the effects of general bone size and density and, b) the effects of sub-chondral bone. We have shown that the association between systemic bone density and osteoarthritis is mainly driven by bone size and new data suggest the importance of bone shape. Further work in our existing cohorts using computerised tomography and conventional radiographs will further explore this important area of research. We will explore the role of sub-chondral bone using MRI and DXA in the VIDEO study, a large randomised trial of vitamin D in patients with OA. Its effect on the success of joint arthroplasty will be explored in the Oxford arthroplasty cohorts.

A number of randomised controlled trials in patients with osteoarthritis have been completed. The current largest study is a three-year trial of the vitamin D supplementation in patients with knee osteoarthritis. As well as determining the role of vitamin D, this study will provide insight into the important mechanisms involved in determining disease progression including: the calcium / vitamin D axis; muscle function; bone mineral density and genetic factors.


Published studies have demonstrated for the first time that the calcium/vitamin D axis can be permanently modified by subtle changes in the early environment. Furthermore, these changes are probably involved in mediating the effects of the early environment on the risk of developing osteoporosis. Studies in our cohort of children have demonstrated that maternal vitamin D concentrations and neonatal calcium concentrations at birth have significant effects on a child’s peak bone mass achieved during childhood, a finding which stimulated a large multi-centre grant application for a trial of vitamin D supplementation during pregnancy, which is successfully proceeding through the funding process. In our adult cohort we have demonstrated, for the first time, a significant interaction between birthweight and genetic factors (vitamin D receptor gene).

Current studies are characterising the interaction between the genome and early environment in the origins of osteoporosis, an important and essential step in combining the important progress achieved in each if these exciting fields. This is being performed in several cohorts: a) 2 cohorts of children exploring the effects on the acquisition of peak bone mass; b) cohort of elderly men and women exploring the effects on bone loss and fracture and (c) a randomised controlled trial of vitamin D supplementation in pregnancy. This will allow us to explore the role of several environmental factors, but focussing on vitamin D, in mediating the effect of the early environment on BMD.

A strong research interest in maintained in secondary osteoporosis. A large cohort of patients with inflammatory bowel disease to assess the rates and mechanisms of bone loss is being followed. We will uniquely use computed tomography in this group of patients to characterise accurately cortical versus trabecular bone loss. A similar cohort is being set up in adult patients with cystic fibrosis.

Other research

Collaboration with a number of local, national and international units to perform epidemiology studies within the fields of: rheumatoid arthritis, vasculitis, obesity and vitamin D metabolism.


Human Development and Health

Affiliate Department(s)

Human Development and Physiology

Research project(s)

FeeTURA4 / Forefoot complications in patients with rheumatoid arthritis: identification, impact and intervention

To date the team at Southampton have led the development and validation of imaging techniques to uniquely determine the longitudinal epidemiology of forefoot complications in patients with rheumatoid arthritis (RA). This provides a substantial basis of expertise to develop work in this area, utilising improved technologies to address the unmet clinical burden of RA disease. A targeted intervention for forefoot complication in patients with RA will be necessary however there is currently limited evidence on which to tailor intervention to individual patients. As such the proposed research will use new generation US technology to facilitate patient assessment, within a community setting, in real time, the results of which will be used to inform a personalised medical approach to management.

COASt (foot): Clinical outcomes in knee arthroplasty and biomechanical foot and ankle assessment

Utilising an established Clinical Outcomes in Arthroplasty Study (COASt) cohort that is currently led by Professor Nigel Arden at both Southampton and Oxford sites; our aim is to determine whether clinical foot and ankle measures are useful in predicting patient reported outcomes following Total Knee Replacement (TKR).

ELFOAB / Epidemiology and lifetime risk of osteoarthritis within the foot and biomechanical functional outcomes

It has been recognized that osteoarthritis (OA) of the foot may have a detrimental effect on patients’ health related quality of life and that foot OA may cause significant morbidity.The specific aims of this research were to develop a detailed understanding of the epidemiology, risk factors and associations of OA occurring within the feet in the general population at middle and older age. An additional aim was to determine lower limb biomechanical factors associated with radiographic foot OA.

Postgraduate Supervision Experience

Previously successful supervision of one PhD student, one MD student and one Research Master’s student who have now all successfully been awarded their degrees. Currently supervising two PhD students who are Allied Health Professionals in the field of Podiatry and Physiotherapy as well as three DPhil students within the Botnar Research Centre.

Currently supervises a number of junior medical staff for all aspects of their clinical research, including study design, statistical analysis and the production of clinical abstracts and full papers.

University examining

Regular examiner at the University of Southampton for 1st year, 3rd year and 5th year written courses and also regularly examined on OSCE stations. Five PhD theses to date.
External examiner for the School of Medicine at the University of Nottingham from 2004 to 2007.


International Osteoporosis Foundation Scientific Ambassador
Member of National Osteoporosis Society Scientific Advisory Board
Member of National Osteoporosis Society Programme Committee
EULAR (European League Against Rheumatism) Osteoarthritis Guideline Committee
EULAR (European League Against Rheumatism) Osteoarthritis Diagnosis Committee
OARSI (Osteoarthritis Research Society International) guidelines committee
OARSI (Osteoarthritis Research Society International) publications committee
OARSI (Osteoarthritis Research Society International) Working Group on Defining OA on MRI
Arthritis Research UK Biomedical Sciences Panel and Fellowship Implementation Committee
Member of; and abstract reviewer for American College of Rheumatology
Arthritis Research UK Pain Centre Advisory Board, University of Nottingham.

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Book Chapter




BM5 Yr2 NS Locomotor System: Symposium – Shoulder Pain

Professor Nigel Arden
Faculty of Medicine, Room AB215, Mailpoint 801, South Academic Block, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD

Room Number: SGH/MRC/MP95

Telephone:(023) 8077 7624
Facsimile:(023) 8070 4021

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