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Anti-TNFs and DMARDs Improve Work Productivity in PsA
June 10 2015 3:39 PM ET — via RheumReports
Work disability is common in psoriatic arthritis (PsA) and is a very important functional outcome. It is a difficult outcome to achieve since there are multiple biological, psychological and social confounders that can contribute to improving presenteeism and work disability. Robust data regarding improvement of work disability after treatment with biologic agents would greatly add to the economic benefits of using these agents.
William Tillett and colleagues from the University of Bath, UK reported on work disability after initiation of anti-TNF and DMARD treatment in PsA. This was an investigator-led, multicenter, observational cohort study (LOPASII) in “real life” PsA patients. Twenty-three hospitals from across the UK were able to collect data on 400 PsA patients, all satisfying the CASPAR criteria. Baseline demographic, socioeconomic, clinical as well as work data were collected prior to initiation of anti-TNF or DMARD therapy. Work disability was assessed using the Work Productivity and Activity Questionnaire (WPAI-SHP).
Of the 400 patients enrolled in this study, 236 were presently working. Unemployed patients were older and had worse physical function as measured by the HAQ. In patients treated with an anti-TNF, presenteeism improved from 40% to 10% (.001) and productivity loss from 45% to 10% (.001). For patients treated with traditional DMARDs, presenteeism improved from 30% to 20% (.001) and productivity loss from 40% to 25% (.001). The difference between the groups became significant at 2 weeks and was sustained to 24 weeks. There were no significant changes in employment level in either treatment group.
This is an important study that demonstrated a significant improvement in presenteeism and productivity loss after initiation of DMARD and anti-TNF treatment. Improvement in work disability was greater and more rapid for those that started an anti-TNF compared to DMARDs.
Reference:
WORK DISABILITY AFTER INITIATION OF ANTI-TNF AND DMARD TREATMENT IN PSORIATIC ARTHRITIS; INVESTIGATOR LED, UK, MULTICENTRE OBSERVATIONAL COHORT STUDY (LOPAS II) [OP0001]
W. Tillett1, G. Shaddick2, A. Jobling2, M. Thomas2, E. Korendowych1, N. McHugh1 on behalf of on behalf of the LOPAS II working group
1Rheumatology, Royal National Hospital for Rheumatic Diseases, 2Department of Mathematical Sciences, University of Bath, Bath, United Kingdom
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About the Author
Dr. Proton Rahman
Proton Rahman, MD is a Clinician Scientist at Memorial University of Newfoundland, where he is also Associate Dean of Clinical Research and a University Research Professor. He practices rheumatology at Eastern Health in St. John’s, Newfoundland.
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