Cost-effectiveness of an adherence-enhancing intervention for gout based on real-world data.


AIM:Medication non-adherence influences outcomes of therapies for chronic diseases. Allopurinol is a cornerstone therapy for patients with gout; however, non-adherence to allopurinol is prevalent in Singapore and limits its effectiveness. Between 2008-2010, an adherence-enhancing program was implemented at the rheumatology division of a public tertiary hospital. The cost-effectiveness of this program has not been fully evaluated. With healthcare resources being finite, the value of investing in adherence-enhancing interventions should be ascertained. This study aims to evaluate the cost-effectiveness of this adherence-enhancing program to inform optimal resource allocation toward better gout management. METHOD:Adopting a real-world data approach, we utilized patient clinical and financial records generated in their course of routine care. Intervention and control groups were identified in a standing database and matched on nine risk factors through propensity score matching. Cost and effect data were followed through 1-2 years. A decision tree was developed in TreeAge using a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty. RESULTS:At an assumed willingness-to-pay threshold of $50 000 USD ($70 000 SGD) per quality-adjusted life year (QALY), the intervention had an 85% probability of being cost-effective compared to routine care. The incremental cost-effectiveness ratio was $12 866 USD per QALY for the base case and ranged from $4 139 to $21 593 USD per QALY in sensitivity analyses. CONCLUSION:The intervention is cost-effective in the short-term, although its long-term cost-effectiveness remains to be evaluated.


Int J Rheum Dis


Lin LW,Teng GG,Lim AYN,Yoong JS,Zethraeus N,Wee HL




Has Abstract


2019-04-01 00:00:00












  • Leprae reaction resembling rheumatologic disease as presenting feature of leprosy.

    abstract::Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with predominant involvement of skin and nerves. We present a 70-year-old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8-week history of worsening neuropathic pain in...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Baharuddin H,Taib T,Zain MM,Ch'ng S

    更新日期:2016-10-01 00:00:00

  • Differential clinical presentation of Adamantiades-Behçet's disease in non-endemic and endemic areas: retrospective data from a Middle-European cohort study.

    abstract:OBJECTIVES:To assess demographical and clinical data in a Middle-European cohort of patients with Adamantiades-Behçet's disease (ABD), together with the use of medication in adherence to international guidelines. METHODS:In a retrospective cohort study, in- and outpatients of an Austrian secondary and tertiary univers...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,多中心研究


    authors: Moosmann T,Veraar C,Brunner J,Fraedrich G,Frech A,Horninger W,Ratzinger G,Streif W,Teuchner B,Willeit J,Zlamy M,De Zordo T,Schirmer M

    更新日期:2018-12-01 00:00:00

  • Histological analysis of synovium by treatment of etanercept for rheumatoid arthritis.

    abstract:AIMS:In order to investigate the histological change in effect attenuation cases of etanercept compared with methotrexate (MTX), we performed immunohistochemical examination by seven different molecules. METHODS:We histologically assessed synovial tissue from five MTX-treated rheumatoid arthritis (RA) patients as cont...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Suzuki Y,Inoue K,Chiba J,Inoue Y,Kanbe K

    更新日期:2009-04-01 00:00:00

  • Dry eye in vitamin D deficiency: more than an incidental association.

    abstract:AIM:The aim of this article is two-fold: (i) to demonstrate the relation between vitamin D deficiency and dry eye and impaired tear function; and (ii) to investigate the possible associations among clinical parameters of hypovitaminosis D with dry eye parameters. METHOD:Fifty premenopausal women with vitamin D deficie...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Yildirim P,Garip Y,Karci AA,Guler T

    更新日期:2016-01-01 00:00:00

  • Translation, cultural adaptation and validation of the WHO fracture risk assessment tool (FRAX(®) ) into Bengali.

    abstract:AIM:To develop a translated and culturally adapted Bengali version of the WHO Fracture Risk Assessment Tool (FRAX(®) ) and to test its feasibility, content validity and reliability. METHOD:The English FRAX was translated and culturally adapted for use in Bangladeshi populations following established forward-backward t...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Islam MN,Ferdous N,Ten Klooster PM,Uddin MS,Nasrin S,Pal B,Rasker JJ

    更新日期:2015-03-01 00:00:00

  • Pulmonary arterial hypertension in systemic lupus erythematosus based on a CSTAR-PAH study: Baseline characteristics and risk factors.

    abstract:AIM:Pulmonary arterial hypertension (PAH) is a complex and devastating complication of systemic lupus erythematosus (SLE). We sought to describe the baseline characteristics of right heart catheterization (RHC)-confirmed SLE-associated PAH and identify risk factors for PAH in SLE patients. METHODS:A multicenter, cross...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,多中心研究


    authors: Zhang N,Li M,Qian J,Wang Q,Zhao J,Yang Z,Tian Z,Zhang X,Zuo X,Zhang M,Zhu P,Ye S,Zhang W,Zheng Y,Qi W,Li Y,Zhang Z,Ding F,Gu J,Liu Y,Wei W,Zeng X

    更新日期:2019-05-01 00:00:00

  • Systemic lupus erythematosus complicated with posterior reversible encephalopathy syndrome and intracranial vasculopathy.

    abstract::Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition characterized by reversible vasogenic edema on neuroimaging. It is associated with various neurological manifestations, including headaches, vomiting, seizures, visual loss, altered mental status and focal neurological deficits. PRES mainly ...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Chen HA,Lin YJ,Chen PC,Chen TY,Lin KC,Cheng HH

    更新日期:2010-10-01 00:00:00

  • NLRP3 p.Q705K and CARD8 p.C10X single nucleotide polymorphisms are not associated with susceptibility to rheumatoid arthritis: a meta-analysis.

    abstract:AIM:Genetic factors have a substantial contribution to the pathogenesis of rheumatoid arthritis (RA). Single nucleotide polymorphisms of NLRP3 p.Q705K and CARD8 p.C10X are two gene mutations that have been linked to many diseases. Here we carried out a meta-analysis to identify their association with susceptibility to ...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,meta分析,评审


    authors: Yang Z,Cao J,Yang Q,Zhang Y,Han L

    更新日期:2017-10-01 00:00:00

  • A low perfusion-metabolic mismatch in 99m Tl and 123 I-BMIPP scintigraphy predicts poor prognosis in systemic sclerosis patients with asymptomatic cardiac involvement.

    abstract:AIM:This study investigated the prognostic factors of cardiac death or cardiac failure using cardiac scintigraphy, echocardiography (UCG), and magnetic resonance imaging (MRI) in asymptomatic systemic sclerosis (SSc) patients. METHODS:We retrospectively evaluated SSc patients who had undergone cardiac scintigraphy usi...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Iida H,Hanaoka H,Okada Y,Kiyokawa T,Takakuwa Y,Yamada H,Okazaki T,Ozaki S,Yamaguchi K,Nakajima Y,Kawahata K

    更新日期:2019-06-01 00:00:00

  • Risk of hepatitis B reactivation in patients receiving anti-tumor necrosis factor-α therapy.

    abstract:OBJECTIVE:The purpose of this study was to determine hepatitis B virus (HBV) screening rates in patients receiving anti-tumor necrosis factor (TNF)-α therapy and the frequency of HBV reactivation in patients with resolved hepatitis B virus infection (hepatitis B surface antigen [HBsAg] negative, hepatitis B core antibo...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Fidan S,Capkın E,Arıca DA,Durak S,Okatan IE

    更新日期:2021-02-01 00:00:00

  • Klinefelter's syndrome and rheumatoid arthritis: report of a case and review of the literature.

    abstract::Kilnefelter's syndrome (KFS) tends to be associated with autoimmune diseases. Although several reports describe association of KFS with different autoimmune diseases, association with rheumatoid arthritis is very rare. We report a case of (KFS) who had seropositive erosive rheumatoid arthritis, and discuss the role of...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,评审


    authors: Al-Arfaj HF

    更新日期:2010-02-01 00:00:00

  • Treat-to-target and shared decision making in rheumatoid arthritis treatment: Is it feasible?

    abstract:AIM:Current rheumatoid arthritis (RA) guidelines have incorporated a treat-to-target (T2T) approach and require that it be implemented through shared decision making (SDM). Current discourse has questioned whether collaborative T2T is feasible in RA, in part because of discrepancies in the way that patients and practit...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Falzer PR

    更新日期:2019-09-01 00:00:00

  • Clinical features and long-term outcomes of 105 granulomatosis with polyangiitis patients: A single center experience from north India.

    abstract:AIM:To describe the clinical features, treatment and long-term outcomes in north Indian patients with granulomatosis with polyangiitis (GPA). METHODS:Clinical details, Birmingham Vasculitis Activity Score (BVAS-v3), laboratory data, histopathology findings, treatment details and outcomes of all consecutive patients di...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Sharma A,Naidu GSRSNK,Rathi M,Verma R,Modi M,Pinto B,Sharma K,Dhir V,Singhal M,Prakash M,Nada R,Panda NK,Minz RW

    更新日期:2018-01-01 00:00:00

  • Usual interstitial pneumonia following resolution of cavitated pulmonary masses in a patient with ANCA-associated vasculitis.

    abstract::A 72-year-old woman with slight pulmonary interstitial reticular markings was initially diagnosed with microscopic polyangiitis (MPA). Two years later, cavitated pulmonary masses appeared, and a biopsy specimen revealed granulomas. Granulomatosis with polyangiitis (GPA) was diagnosed. The masses resolved with treatmen...

    journal_title:International journal of rheumatic diseases



    authors: Fukui S,Kobayashi S,Kamei S,Takizawa Y,Setoguchi K,Hishima T

    更新日期:2018-04-01 00:00:00

  • Salivary and serum cathelicidin LL-37 levels in subjects with rheumatoid arthritis and chronic periodontitis.

    abstract:INTRODUCTION:Rheumatoid arthritis (RA) is associated with chronic periodontitis (CP) due to shared risk factors, immuno-genetics and tissue destruction pathways. Human cathelicidin LL-37 has been suggested as a possible mechanistic link for these diseases. This study investigated the levels of salivary and serum LL-37 ...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Cheah CW,Al-Maleki AR,Vadivelu J,Danaee M,Sockalingam S,Baharuddin NA,Vaithilingam RD

    更新日期:2020-08-02 00:00:00

  • Characteristics and risk factors of pulmonary arterial hypertension in patients with primary Sjögren's syndrome.

    abstract:AIM:To describe baseline characteristics of patients with primary Sjögren's syndrome (pSS) with right heart catheterization (RHC)-confirmed pulmonary arterial hypertension (PAH) and explore risk factors for PAH in pSS. METHODS:This case-control study included consecutive patients hospitalized with pSS-PAH from 2007 to...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Yan S,Li M,Wang H,Yang X,Zhao J,Wang Q,Liu Y,Lai J,Tian Z,Song H,Zhao Y,Zeng X

    更新日期:2018-05-01 00:00:00

  • Fatty acid binding protein 3 is associated with skeletal muscle strength in polymyositis and dermatomyositis.

    abstract:OBJECTIVE:To determine serum levels and histopathological characteristics of fatty acid binding protein 3 (FABP3) in patients with polymyositis (PM) and dermatomyositis (DM), and to evaluate the correlation between the FABP3 and muscle strength. METHODS:The study population included 24 subjects with PM/DM, 12 subjects...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Zhang L,Zhou H,Peng Q,Jiang W,Qiao W,Wang G

    更新日期:2017-02-01 00:00:00

  • No increased risk of herpes zoster in TNF inhibitor and non-TNF inhibitor users with rheumatoid arthritis: epidemiological study using the Japanese health insurance database.

    abstract:OBJECTIVE:It is controversial whether the use of biological disease-modifying antirheumatic drugs (DMARDs) increases the risk of herpes zoster (HZ). We aimed to evaluate the risks of HZ in tumor necrosis factor inhibitor (TNFI) and non-TNFI users with rheumatoid arthritis (RA) over 3 years in Japan. METHOD:Using the J...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Sakai R,Kasai S,Hirano F,Harada S,Kihara M,Yokoyama W,Tsutsumino M,Nagasaka K,Koike R,Yamanaka H,Miyasaka N,Harigai M

    更新日期:2018-09-01 00:00:00

  • Taiwan Rheumatology Association consensus recommendations for the management of axial spondyloarthritis.

    abstract:AIM:To establish guidelines for the clinical management of axial spondyloarthritis that take into account local issues and clinical practice concerns for Taiwan. METHOD:Overarching principles and recommendations were established by consensus among a panel of rheumatology and rehabilitation experts, based on analysis o...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,评审


    authors: Wei JC,Liu CH,Tseng JC,Hsieh LF,Chen CH,Chen HH,Chen HA,Chen YC,Chou CT,Liao HT,Lin YC,Luo SF,Yang DH,Yeo KJ,Tsai WC,Taiwan Rheumatology Association (TRA).

    更新日期:2020-01-01 00:00:00

  • The immunological basis of B-cell therapy in systemic lupus erythematosus.

    abstract::Loss of B-cell tolerance is a hallmark feature of the pathogenesis in systemic lupus erythematosus (SLE), an autoimmune disease that is characterized by hypergammaglobulinemia and autoantibody production. These autoantibodies lead to formation of immune-complex deposition in internal organs causing inflammation and da...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,评审


    authors: Mok MY

    更新日期:2010-02-01 00:00:00

  • Antioxidant profile in patients with complex regional pain syndrome type I.

    abstract:OBJECTIVE:Complex regional pain syndrome (CRPS) type I is one of the most important problems with regard to physical medicine and rehabilitation. CRPS may cause not only higher therapeutic costs but also greater work time loss. The mechanism and pathogenesis of CRPS still remains unknown. Some findings indicating oxida...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Baykal T,Seferoglu B,Karsan O,Kiziltunc A,Senel K

    更新日期:2014-02-01 00:00:00

  • Influence of disease duration and socioeconomic factors on the prevalence of infection and hospitalization in rheumatoid arthritis: KRAC study.

    abstract:AIM:The use of healthcare resources by rheumatoid arthritis (RA) patients can be related to the presence of disease, comorbid conditions, use of steroids, and the combined use of immunosuppressants. This study evaluated the risk factors associated with infection and hospitalization in RA. METHODS:This multicenter, cro...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,多中心研究


    authors: Chandrashekara S,Shobha V,Dharmanand BG,Jois R,Kumar S,Mahendranath KM,Haridas V,Prasad S,Singh Y,Daware MA,Swamy A,Subramanian R,Somashekar SA,Shanthappa AM,Anupama KR

    更新日期:2019-07-01 00:00:00

  • A retrospective study on 158 Thai patients with juvenile idiopathic arthritis followed in a single center over a 15-year period.

    abstract:AIM:To determine the outcomes of juvenile idiopathic arthritis (JIA) in Thai children. METHODS:A retrospective cohort study. All JIA patients in a rheumatology clinic, Ramathibodi Hospital, between July 1997 and December 2012 were enrolled. The patient data were reviewed from medical records. At the most recent follow...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Vilaiyuk S,Soponkanaporn S,Jaovisidha S,Benjaponpitak S,Manuyakorn W

    更新日期:2016-12-01 00:00:00

  • Performance evaluation of a line blot assay system for detection of anti-PM-Scl antibody in Japanese patients with systemic sclerosis.

    abstract:OBJECTIVE:To evaluate the performance of a line blot (LB) assay for identifying anti-PM-Scl antibody (Ab). METHODS:We screened 56 serum samples from systemic sclerosis patients using a protein immunoprecipitation (IP) assay and an LB assay (Systemic Sclerosis Profile Euroline® Blot test kit) to detect anti-PM-Scl Ab. ...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Hamaguchi Y,Kuwana M,Takehara K

    更新日期:2019-09-01 00:00:00

  • Effect of anti-interleukin-1 treatment on quality of life in children with colchicine-resistant familial Mediterranean fever: A single-center experience.

    abstract:AIM:The aim of this study is to evaluate the clinical parameters, acute-phase reactants, side effects, genetic mutations among colchicine-resistant Familial Mediterranean fever (FMF) patients who received anti-interleukin-1 (anti-IL-1) treatment. We also evaluate the quality of life and school attendance among colchici...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Kurt T,Aydın F,Nilüfer Tekgöz P,Sezer M,Uncu N,Çelikel Acar B

    更新日期:2020-07-01 00:00:00

  • Impact of peer-led group education on the quality of life in patients with ankylosing spondylitis.

    abstract:OBJECTIVES:To determine the effect of peer-led group education on the quality of life and depression in patients with ankylosing spondylitis (AS). METHODS:Eighty patients with definite AS were allocated randomly to either the education or control group. The education group (n = 40) was subjected to a peer-led group ed...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章,随机对照试验


    authors: Kaya T,Goksel Karatepe A,Atici Ozturk P,Gunaydin R

    更新日期:2016-02-01 00:00:00

  • PPARγ agonist rosiglitazone inhibits migration and invasion by downregulating Cyr61 in rheumatoid arthritis fibroblast-like synoviocytes.

    abstract:AIM:Peroxisome proliferator-activated receptor gamma (PPARγ) agonists have anti-inflammatory properties that reduce inflammatory cytokine production in rheumatoid arthritis (RA). Cysteine-rich angiogenic inducer 61 (Cyr61) is associated with diseases related to chronic inflammation. The aim of this study was to investi...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Kwon EJ,Park EJ,Choi S,Kim SR,Cho M,Kim J

    更新日期:2017-10-01 00:00:00

  • Association between core stability and physical function, functional performance in patients with systemic sclerosis.

    abstract:OBJECTIVE:To investigate the association of core stability with physical function and functional performance in patients with systemic sclerosis (SSc). METHODS:Forty patients who met the American College of Rheumatology / European League Against Rheumatism 2013 classification criteria for SSc were included in the cros...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Yakut H,Özalevli S,Birlik AM

    更新日期:2021-01-19 00:00:00

  • Serum soluble toll-like receptor 2: a novel biomarker for systemic lupus erythematosus disease activity and lupus-related cardiovascular dysfunction.

    abstract:AIM:To assess the serum levels of soluble toll-like receptor (sTLR2) as an endogenous negative regulator of TLR2 signaling in systemic lupus erythematosus (SLE) patients, to investigate the correlation between sTLR2 and SLE disease activity index (SELDAI), SLE-related cardiovascular risk factors and ventricular dysfunc...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: Houssen ME,El-Mahdy RH,Shahin DA

    更新日期:2016-07-01 00:00:00

  • Anti-alanyl tRNA positive antisynthase syndrome with Kaposi sarcoma.

    abstract::We report a rare case of antisynthase syndrome (ASS) complicated with Kaposi sarcoma, analyze its clinical characteristics, and review the literature on the topic. An 80-year-old male patient developed fever, cough, and shortness of breath. Lung high-resolution computed tomography showed nonspecific interstitial pneum...

    journal_title:International journal of rheumatic diseases

    pub_type: 杂志文章


    authors: He N,Lu D,Xue J,Wang X

    更新日期:2020-06-01 00:00:00