Understanding the pathogenesis of axSpA to contribute to the development of novel drugs
Looking into novel methods in enabling earlier diagnosis of axSpA
Identifying and validating patient-reported outcomes to better assess treatment efficacy
Exploring the effectiveness of Traditional Chinese medicine (TCM) in the collaborative care for patients with axSpA
Development of a humanised mouse model for axSpAAnimal testing is required during the pre-clinical phase of drug development, but differences in the immune systems of animal models and human might cause discrepancies in the interpretation of results. This study is a collaboration with A*STAR, to develop a humanised mouse model for axSpA and provide a better simulation of in vivo biological systems, which will help in future studies.
Validation of the diagnostic criteria of axSpAThis study is part of an international collaboration with Assessment of SpondyloArthritis International Society (ASAS) to validate the current ASAS diagnostic and classification criteria of axSpA. If successful, this might facilitate the early institution of treatment and subsequently, an improvement in treatment efficacy.
Identifying and validating patient-reported outcomesPatient-reported outcomes (PROs) are self-reported questionnaires which provide valuable insight about patients’ health conditions and are important for clinicians when assessing treatment benefits. We have conducted several studies to validate PROs related to axSpA, and have used the information obtained to better assess patient treatment outcomes.
Exploring the effectiveness of TCM in the collaborative care for patients with axSpAWe have embarked on multiple clinical trials under this theme, in collaboration with Singapore Thong Chai Medical Institution. One of the trials aims to investigate the effectiveness of manual acupuncture in addition to current standard of care, which includes western medication, Rheumatologist, physiotherapy, etc. compared to just western medication for patients with inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs). Another trial is looking into comparing the effectiveness of manual acupuncture to electro-acupuncture. We are also looking into elucidating the effect of acupuncture on the immune profiles of patients.
Kwan YH, Tan JJ, Phang JK, Fong W, Lim KK, Koh HL, Lui NL, Tan CS, Østbye T, Thumboo J, Leung YY. Validity and reliability of the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with axial spondyloarthritis (axSpA) in Singapore. Int J Rheum Dis. 2019 Dec;22(12):2206-2212. https://doi.org/10.1111/1756-185X.13735.
Png K, Kwan YH, Leung YY, Phang JK, Lau JQ, Lim KK, Chew EH, Low LL, Tan CS, Thumboo J, Fong W, Østbye T. Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review. Semin Arthritis Rheum. 2018 Oct;48(2):274-282. https://doi.org/10.1016/j.semarthrit.2018.02.016.
Seng JJB, Kwan YH, Low LL, Thumboo J, Fong WSW. Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis. Biomarkers. 2018 May-Jun;23(4):335-338. https://doi.org/10.1080/1354750X.2018.1425916.
Phang JK, Kwan YH, Goh H, Tan VIC, Thumboo J, Østbye T, Fong W. Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials. Complement Ther Med. 2018 Apr;37:143-157. https://doi.org/10.1016/j.ctim.2018.03.003.
Kwan YH, Fong W, Lui NL, Yong ST, Cheung YB, Malhotra R, Thumboo J, Østbye T. Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore. Int J Rheum Dis. 2018 Mar;21(3):699-704. https://doi.org/10.1111/1756-185X.12989.
Kwan YH, Fong W, Tan VIC, Lui NL, Malhotra R, Østbye T, Thumboo J. A systematic review of quality-of-life domains and items relevant to patients with spondyloarthritis. Semin Arthritis Rheum. 2017 Oct;47(2):175-182. https://doi.org/10.1016/j.semarthrit.2017.04.002.
Goh H, Kwan YH, Seah Y, Low LL, Fong W, Thumboo J. A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases. Rheumatol Int. 2017 Oct;37(10):1619-1628. https://doi.org/10.1007/s00296-017-3763-9.
Lee YX, Kwan YH, Png WY, Lim KK, Tan CS, Lui NL, Chew EH, Thumboo J, Østbye T, Fong W. Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population. Clin Rheumatol. 2017 Oct;36(10):2365-2370. https://doi.org/10.1007/s10067-017-3585-x.
Kwan YH, Fong WW, Lui NL, Yong ST, Cheung YB, Malhotra R, Østbye T, Thumboo J. Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore. Rheumatol Int. 2016 Dec;36(12):1759-1765. https://doi.org/10.1007/s00296-016-3567-3.
Fong W, Holroyd C, Davidson B, Armstrong R, Harvey N, Dennison E, Cooper C, Edwards CJ. The effectiveness of a real life dose reduction strategy for tumour necrosis factor inhibitors in ankylosing spondylitis and psoriatic arthritis. Rheumatology (Oxford). 2016 Oct;55(10):1837-42. https://doi.org/10.1093/rheumatology/kew269.
