{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T06:40:42Z","timestamp":1696056042556},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Abbvie for conduction of the consensus meeting"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The beneficial effects of biologic disease\u2010modifying anti\u2010rheumatic drugs (<jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content>s), such as tumour necrosis factor inhibitors (anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) in active ankylosing spondylitis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>) are well established. The significant costs on patients in the absence of financial subsidization can limit their use. The objective was to describe a consensus development process on recommendations for government\u2010assisted funding of biologic therapy for <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> patients in Singapore.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Evidence synthesis followed by a modified <jats:styled-content style=\"fixed-case\">RAND<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">UCLA<\/jats:styled-content> Appropriateness Method (<jats:styled-content style=\"fixed-case\">RAM<\/jats:styled-content>) was used. Eleven rheumatologists rated indications for therapies for different proposed clinical scenarios. Points reflecting the output from the formal group consensus were used to formulate 10 practice recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>It was agreed that a <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content> (anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) is indicated if a patient has active <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> with a Bath Ankylosing Spondylitis Activity Index (<jats:styled-content style=\"fixed-case\">BASDAI<\/jats:styled-content>) \u2265\u00a04 and spinal pain of \u2265\u00a04\u00a0cm on visual analogue scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) on two occasions at least 12\u00a0weeks apart, despite being on a minimum of two sequential non\u2010steroidal anti\u2010inflammatory drugs at maximal tolerated dose for at least 4\u00a0weeks, in addition to adherence to an appropriate physiotherapy program for at least 3\u00a0months. To qualify for continued biologic therapy, a patient must have documentation of response every 3\u00a0months and at least 50% improvement in <jats:styled-content style=\"fixed-case\">BASDAI<\/jats:styled-content> and reduction of spinal pain <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> \u2265\u00a02\u00a0cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A validated and feasible consensus process can enable pragmatic standardized recommendations to be developed for <jats:styled-content style=\"fixed-case\">bDMARD<\/jats:styled-content> subsidization for <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> patients in a local Asian context.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12707","type":"journal-article","created":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T21:08:36Z","timestamp":1436908116000},"page":"1517-1526","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Consensus development on eligibility of government subsidisation of biologic disease modifying anti\u2010rheumatic agents for treatment of ankylosing spondylitis: The Singapore experience"],"prefix":"10.1111","volume":"20","author":[{"given":"Peter P.","family":"Cheung","sequence":"first","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjari","family":"Lahiri","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gim\u2010Gee","family":"Teng","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai\u2010Lee","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith L.","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Allergy and Immunology Tan Tock Seng Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dow\u2010Rhoon","family":"Koh","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei\u2010Howe","family":"Koh","sequence":"additional","affiliation":[{"name":"Koh Wei Howe Arthritis &amp; Rheumatism Medical Clinic Mount Elizabeth Medical Centre Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swee\u2010Cheng","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine Khoo Teck Puat Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Medicine Alexandra Hospital (Jurong Health) Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khai\u2010Pang","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Allergy and Immunology Tan Tock Seng Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita Y. 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