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Review
. 2020 Feb;23(2):153-164.
doi: 10.1111/1756-185X.13754. Epub 2019 Nov 24.

Singapore chapter of rheumatologists' updated consensus statement on the eligibility for government subsidization of biologic and targeted therapy for the treatment of psoriatic arthritis

Cheryl K T Chua  1 , Gim Gee Teng  1   2 , Peter P Cheung  1   2 , Warren Weng Seng Fong  3 , Keng Hong Leong  4 , Ying Ying Leung  3 , Anita Y N Lim  1   2 , Nai Lee Lui  5 , Mona Manghani  6 , Amelia Santosa  1   2 , Melonie Kannamma Sriranganathan  7 , Ernest Suresh  8 , Teck Choon Tan  9 , Manjari Lahiri  1   2
Affiliations
Review

Singapore chapter of rheumatologists' updated consensus statement on the eligibility for government subsidization of biologic and targeted therapy for the treatment of psoriatic arthritis

Cheryl K T Chua et al. Int J Rheum Dis. 2020 Feb.

Abstract

Aim: There have been major advances in biologic treatment options for psoriatic arthritis (PsA) since the publication of the 2015 consensus recommendations by the Chapter of Rheumatologists, College of Physicians, Academy of Medicine, Singapore, for government-assisted funding, thus warranting a revision of this guideline.

Methods: Recent trials and nine published guidelines on the use of biologic therapy for PsA were reviewed. Based on the synthesized evidence, a task force panel (TFP), consisting of 10 practicing rheumatologists in Singapore, rated the statements pertaining to the use of biologic therapy, using a modified Delphi approach. Consensus was obtained if >70% agreed on a statement.

Results: The TFP agreed on 10 recommendations pertaining to the initiation, choice and continuation of biologic therapy. A biologic is indicated in patients with PsA: (a) with at least three swollen and tender joints, digits or entheses; and (b) who have failed at least two conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) strategies for a minimum of 3 months each. Any approved drug class including tumor necrosis factor inhibitors, interleukin-17 inhibitors (IL-17i), IL-12/23i or targeted synthetic DMARDs may be considered as first-line treatment, and continued only if a response is achieved by 6 months.

Conclusion: These recommendations developed through a formal consensus method may be useful to guide funding considerations for appropriate and equitable use of biologic therapy for eligible patients with PsA.

Keywords: biologic therapy; consensus; psoriatic arthritis; recommendations.

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References

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