Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.(Taehan Chang Yŏn'gu Hakhoe, 2019) Ooi, C.J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C.; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D.I.; Ling, K.L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E.; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S.K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and ColitisABSTRACT: The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.Item Incidence and Phenotype of Inflammatory Bowel Disease From 13 Countries in Asia-Pacific: Results From the Asia-Pacific Crohn's and Colitis Epidemiologic Study 2011-2013(American Gastroenterological Association(AGA) Institute, Published by Elsevier Inc., 2016) Ng, S.C.; Kaplan, G.; Banerjee, R.; Wei, Shu-Chen; Tang, Whitney; Zeng, Z.; Chen, Min-hu; Yang, H.; de Silva, H.J.; Niriella, M.A.; Ong, D.E.; Ling, Khoon-Lin; Hilmi, I; Pisespongsa, P.; Aniwan, S.; Limsrivilai, J.; Abdullah, M.; Chong, V.H.; Cao, Q.; Miao, Y.; Ong-Go, A.K.; Bell, S.; Niewiadomski, O.; Kamm, M.A.; Ng, K.K.; Yu, H.H.; Wang, Yu-Fang; Ouyang, Q.; Goh, K.L.; Lin, Hung-Hsin; Lin, Wei-Chen; Wu, K.; Simadibrata, M.; Chan, F.K.; Sung, J.Background: The Asia-Pacific Crohn's and Colitis Epidemiology Study, initiated in 2011, aimed to determine the incidence and phenotype of inflammatory bowel disease (IBD) in Asia-Pacific. We herein present incidence and phenotype data from 2011 through 2013 for 12 countries or areas in Asia (Brunei, China, Hong Kong, India, Indonesia, Macau, Malaysia, Philippines, Singapore, Sri Lanka, Taiwan, Thailand) and Australia. Methods: We performed a prospective, population-based study of IBD incidence in predefined catchment areas using a web-based database. New cases were diagnosed based on standard criteria and ascertained from multiple sources. Endoscopy, pathology, and pharmacy records were searched for completeness of case capture. Age-standardized incidence was calculated with 95% confidence interval (CI). Crude incidence in different regions within Asia was pooled together using a random effect model. Results: We identified 1,572 new IBD patients (2011-2012, n=419; 2012-2013, n=1,153; 131 from Australia) including 1,057 (67%) ulcerative colitis (UC) and 515 (33%) Crohn's disease (CD). The mean annual incidence for IBD per 100,000 was 1.68 (95% CI, 1.59-1.77) in Asia and 22.28 (95% CI, 18.48-26.71) in Australia. The three countries within Asia with the highest incidence per 100,000 was India (9.31; 95% CI, 8.38-10.31), China (Guangzhou) (3.30; 95% CI, 2.68-4.06) and Hong Kong (2.58; 95% CI, 2.20-3.03). Within five regions of China, IBD incidence varied from 0.49 to 3.30 per 100,000. Pooled incidence of UC and CD within East Asia (China, Macau, Hong Kong, Taiwan) was 1.12 (95% CI, 0.77-1.48) and 0.33 (95% CI, 0.17-0.49), respectively. Pooled incidence of UC and CD within South East Asia (Brunei, Malaysia, Singapore, Indonesia, Thailand, Philippines) was 0.38 (0.21-0.55) and 0.30 (95% CI, 0.22-0.38), respectively. Ratio of UC:CD was 2.21 in Asia and 0.64 in Australia. Median time from symptom onset to diagnosis was 3 months [interquartile range (IQR), 2-10] for UC and 7 months (IQR 2-19) for CD. Stricturing, penetrating and perianal CD at diagnosis was common (21%, 10% and 17%, respectively) in Asia. Conclusion: Robust large-scale comparative epidemiologic IBD data from newly industrialized countries are emerging. Incidence of IBD varies throughout Asia with a higher incidence in East than South-East Asia. Complicated CD at diagnosis remains prevalent in Asia. Emergence of IBD in Asia will result in the need for specific health-care resources.Item Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.(Blackwell Scientific Publications, 2019) Ooi, C. J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D. I.; Ling, K. L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S. K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and ColitisThe Asia Pacific Working Group on Inflammatory Bowel Disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis (AOCC). With biological agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biological agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible Hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.