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In order to reflect these developments, we aimed to update the local consensus recommendations for subsidization of biologics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A modified Delphi approach was used. Six published guidelines from major rheumatology societies and healthcare authorities on axSpA were reviewed. Findings were synthesized and used in formulating updated recommendation statements. Recommendations were rated by 10 practicing rheumatologists in Singapore. Consensus was reached if there was more than 70% agreement or disagreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten statements achieved consensus. Patients may be considered for subsidization of biologic therapy if they fulfill the Assessment of Spondyloarthritis International Society or modified New York criteria, with persistently active disease (defined either by Ankylosing Spondylitis Disease Activity Score\u00a0\u2265\u00a02.1 or Bath Spondylitis Disease Activity Index\u00a0\u2265\u00a04), despite 4\u00a0weeks of full\u2010dose non\u2010steroidal anti\u2010inflammatory drugs and regular exercise. Either tumor necrosis factor inhibitors or interleukin 17 inhibitors may be used as first\u2010line therapy, and should be continued if adequate response is achieved at 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recommendation statements were formulated through a formal consensus process by local experts with a view to assist relevant authorities in funding considerations and for use in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13744","type":"journal-article","created":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T06:38:30Z","timestamp":1574663910000},"page":"165-173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Update on recommendations for eligibility of government subsidization of biologic disease\u2010modifying antirheumatic drugs for the treatment of axial spondyloarthritis in Singapore"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0121-5487","authenticated-orcid":false,"given":"Kee Fong","family":"Phang","sequence":"first","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3482-6017","authenticated-orcid":false,"given":"Manjari","family":"Lahiri","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren Weng Seng","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keng Hong","family":"Leong","sequence":"additional","affiliation":[{"name":"Leong Keng Hong Arthritis and Medical Clinic Gleneagles Medical Centre Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8492-6342","authenticated-orcid":false,"given":"Ying Ying","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology Singapore General Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita Yee Nah","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Rheumatology University Medicine Cluster National University Health System Singapore Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai Lee","family":"Lui","sequence":"additional","affiliation":[{"name":"Lui Centre for Arthritis &amp; 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