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Spinal Diseases: HELP
Articles by Gim-Gee Teng
Based on 2 articles published since 2008
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Between 2008 and 2019, Gim-Gee Teng wrote the following 2 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline Singapore Chapter of Rheumatologists consensus statement on the eligibility for government subsidy of biologic disease modifying anti-rheumatic agents for the treatment of psoriatic arthritis. 2017

Lahiri, Manjari / Teng, Gim-Gee / Cheung, Peter P / Suresh, Ernest / Chia, Faith L / Lui, Nai-Lee / Koh, Dow-Rhoon / Koh, Wei-Howe / Leong, Khai-Pang / Lim, Anita Y N / Ng, Swee-Cheng / Thumboo, Julian / Lau, Tang-Ching / Leong, Keng-Hong. ·Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. · Department of Medicine, Alexandra Hospital (Jurong Health), Singapore, Singapore. · Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore. · Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore. · Koh Wei Howe Arthritis & Rheumatism Medical Clinic, Mount Elizabeth Medical Centre, Singapore, Singapore. · Leong Keng Hong Arthritis and Medical Clinic, Gleneagles Medical Centre, Singapore, Singapore. ·Int J Rheum Dis · Pubmed #26353916.

ABSTRACT: AIM: In Singapore, patients with psoriatic arthritis (PsA) constitute a significant disease burden. There is good evidence for the efficacy of anti-tumor necrosis factor (anti-TNF) in PsA; however cost remains a limiting factor. Non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) hence remain the first-line treatment option in PsA in spite of limited evidence. The Singapore Chapter of Rheumatologists aims to develop national guidelines for clinical eligibility for government-assisted funding of biologic disease modifying anti- rheumatic drugs (bDMARDs) for PsA patients in Singapore. METHODS: Evidence synthesis was performed by reviewing seven published guidelines on use of biologics for PsA. Using the modified Research and Development/University of California at Los Angeles Appropriateness Method (RAM), rheumatologists rated indications for therapies for different clinical scenarios. Points reflecting the output from the formal group consensus were used to formulate the practice recommendations. RESULTS: Ten recommendations were formulated relating to initiation, continuation and options of bDMARD therapy. The panellists agreed that a bDMARD is indicated if a patient has active PsA with at least five swollen and tender joints, digits or entheses and has failed two nbDMARD strategies at optimal doses for at least 3 months each. Any anti-TNF may be used and therapy may be continued if an adequate PsARC response is achieved by 3 months after commencement. CONCLUSION: The recommendations developed by a formal group consensus method may be useful for clinical practice and guiding funding decisions by relevant authorities in making bDMARD usage accessible and equitable to eligible patients in Singapore.

2 Guideline Consensus development on eligibility of government subsidisation of biologic disease modifying anti-rheumatic agents for treatment of ankylosing spondylitis: The Singapore experience. 2017

Cheung, Peter P / Lahiri, Manjari / Teng, Gim-Gee / Lui, Nai-Lee / Chia, Faith L / Koh, Dow-Rhoon / Koh, Wei-Howe / Ng, Swee-Cheng / Suresh, Ernest / Leong, Khai-Pang / Lim, Anita Y N / Thumboo, Julian / Lau, Tang-Ching / Leong, Keng-Hong. ·Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Department of Rheumatology and Immunology, Singapore General Hospital, Singapore. · Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore. · Koh Wei Howe Arthritis & Rheumatism Medical Clinic, Mount Elizabeth Medical Centre, Singapore. · Department of Medicine, Khoo Teck Puat Hospital, Singapore. · Department of Medicine, Alexandra Hospital (Jurong Health), Singapore. · Leong Keng Hong Arthritis and Medical Clinic, Gleneagles Medical Centre, Singapore. ·Int J Rheum Dis · Pubmed #26177789.

ABSTRACT: INTRODUCTION: The beneficial effects of biologic disease-modifying anti-rheumatic drugs (bDMARDs), such as tumour necrosis factor inhibitors (anti-TNF) in active ankylosing spondylitis (AS) 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-assisted funding of biologic therapy for AS patients in Singapore. METHODS: Evidence synthesis followed by a modified RAND/UCLA Appropriateness Method (RAM) 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. RESULTS: It was agreed that a bDMARD (anti-TNF) is indicated if a patient has active AS with a Bath Ankylosing Spondylitis Activity Index (BASDAI) ≥ 4 and spinal pain of ≥ 4 cm on visual analogue scale (VAS) on two occasions at least 12 weeks apart, despite being on a minimum of two sequential non-steroidal anti-inflammatory drugs at maximal tolerated dose for at least 4 weeks, in addition to adherence to an appropriate physiotherapy program for at least 3 months. To qualify for continued biologic therapy, a patient must have documentation of response every 3 months and at least 50% improvement in BASDAI and reduction of spinal pain VAS ≥ 2 cm. CONCLUSION: A validated and feasible consensus process can enable pragmatic standardized recommendations to be developed for bDMARD subsidization for AS patients in a local Asian context.