Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Gout: HELP
Articles by Cynthia Sung
Based on 1 article published since 2008
||||

Between 2008 and 2019, Cynthia Sung wrote the following article about Gout.
 
+ Citations + Abstracts
1 Article Cost-effectiveness analysis of genotyping for HLA-B*5801 and an enhanced safety program in gout patients starting allopurinol in Singapore. 2015

Dong, Di / Tan-Koi, Wei-Chuen / Teng, Gim Gee / Finkelstein, Eric / Sung, Cynthia. ·Health Services & Systems Research Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. · Vigilance & Compliance Branch, Health Sciences Authority, 11 Biopolis Way, #11-01, Helios, Singapore 138667, Singapore. · Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore 117549, Singapore. · Division of Rheumatology, National University Health System, University Medicine Cluster, Singapore. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Emerging Infectious Diseases Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. ·Pharmacogenomics · Pubmed #26554739.

ABSTRACT: AIMS: Allopurinol is an efficacious urate-lowering therapy (ULT), but is associated with rare serious adverse drug reactions of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), with higher risk among HLA-B*5801 carriers. We assessed the cost-effectiveness of HLA-B*5801 testing, an enhanced safety program or strategies with both components. METHODS: The analysis adopted a health systems perspective and considered Singaporean patients with chronic gout, over a lifetime horizon, using allopurinol or probenecid. The model incorporated SJS/TEN and gout treatment outcomes, allele frequencies, drug prices and other medical costs. RESULTS: Based on cost-effectiveness threshold of US$50,000 per quality-adjusted life year, HLA-B*5801-guided ULT selection or enhanced safety program was not cost effective. Avoidance of ULTs was the least preferred strategy as uncontrolled gout leads to lower quality-adjusted life years and higher costs. CONCLUSION: The analysis underscores the need for biomarkers with higher positive predictive value for SJS/TEN, less expensive genetic tests or safety programs, or more effective gout drugs. .