Improvement in work place and household productivity for patients with early rheumatoid arthritis treated with adalimumab plus methotrexate: Work outcomes and their correlations with clinical and radiographic measures from a randomized controlled trial companion study

Abstract

Objective. To evaluate household and work place outcomes for patients with rheumatoid arthritis (RA) who were homemakers or employed workers, respectively, and who were treated with adalimumab plus methotrexate versus methotrexate monotherapy. We also determined baseline predictors of household and work place outcomes. Methods. Data were from a health economic companion study to PREMIER, a 2-year, randomized controlled trial of methotrexate-naive patients with early RA (<3 years) who received treatment with adalimumab plus methotrexate, adalimumab, or methotrexate. Absenteeism (number of days missed or unfit to work), presenteeism (self-judgment of the effects of RA on job or household performance), and employment status were collected from self-reports at baseline and varying time points during the study. Results. Household and work place outcomes were generally similar for homemakers and employed workers. Over 2 years, patients who received combination therapy missed approximately half as many days as patients who received methotrexate (17.4 versus 36.9 days for employed workers; 7.9 versus 18.6 days for homemakers). Presenteeism was lower (reflecting better productivity) for combination therapy than methotrexate monotherapy. The likelihood of gaining/ retaining employment over 2 years was greater for combination therapy than methotrexate monotherapy (odds ratio 1.530, 95% confidence interval 1.038 -2.255; P ‫؍‬ 0.0318). Baseline radiographic progression was an independent predictor for retaining/gaining employment at 2 years. Conclusion. Compared with methotrexate monotherapy, combination therapy was associated with more positive work outcomes: less absenteeism, less presenteeism, and greater likelihood of gaining/retaining employment. Radiographic progression at baseline was predictive of the ability to retain or gain employment.

Rheumatoid arthritis and work: The impact of rheumatoid arthritis on absenteeism and presenteeism

“…Those patients who responded to anti-tumour necrosis factor (TNF) therapy were, however, less likely to become work-disabled. In the PREMIER study, an RCT comparing adalimumab plus methotrexate (MTX) with MTX alone, patients receiving the combination therapy were 1.53 (95% CI: 1.04e2.56) times more likely to retain/regain employment [19].…”

“…A few studies used validated questionnaires to estimate the number of days absent including the Work Productivity Survey for Rheumatoid Arthritis (WPS-RA) [23,25], Health Labour Questionnaire (HLQ) [29] and Work Productivity and Activity Impairment questionnaire (WPAI-RA) [31,40]. In two studies, Short Form (SF)36 or Health Assessment Questionnaire (HAQ) scores were mapped onto existing measures of presenteeism (i.e., WPAI and Work Limitation Questionnaire (WLQ)) using regression techniques to estimate the inability to work [21] and the number of days missed due to absenteeism/presenteeism [24], whereas a zero-inflated Poisson (ZIP) model, which accounts for excessive zero values in absenteeism, was used in another study [19]. In patients with early RA (a disease duration of <2 years), a significant decrease in absent workdays was observed after commencement of biologic therapy [19,20,22,24], except in the study by Eriksson …”

Does Combined Clinical and Ultrasound Assessment Allow Selection of Individuals With Rheumatoid Arthritis for Sustained Reduction of Anti–Tumor Necrosis Factor Therapy?

“…In the treatment of rheumatoid arthritis (RA), biologic therapies, including anti-tumor necrosis factor (anti-TNF) inhibitors, reduce disease activity (1)(2)(3), preserve physical function, and prevent joint damage and consequent disability (4)(5)(6)(7). Current guidelines for the management of RA propose rapid escalation of drug treatment to control 1 disease activity (8,9).…”

Identification of cytomegalovirus (CMV)pp65 antigen-specific human monoclonal antibodies using single B cell-based antibody gene cloning from melanoma patients

“…The advanced technology of antibody engineering has promoted strongly the development of novel antibody therapeutics [3,4]. Especially, the trend of antibody development is moving from mouse/human chimera to fully human monoclonal antibodies (mAbs) [5,6], resulting in clinical applications in cancer and auto-immune disease patients [7,8]. In the last decade, investigational approaches using clinical samples for fully human mAb production have been performed [9,10], but there are still problems with efficiency and accuracy of antibody production, which should be solved.…”