Abstract
Objectives: To access the cost of illness, quality of life and work limitation in active ankylosing spondylitis (AS) patients using adalimumab in China.Methods: A prospective study was performed in 91 patients with active AS in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS with the Bath Ankylosing Spondylitis Disease Activity Index ≥ 4 were enrolled. All participants received adalimumab (40 mg per 2 weeks) therapy and completed questionnaires about disease characteristics, quality of life and cost. Only patients with pay-work completed the Work Limitation Questionnaire and Work productivity and activity impairment questionnaire in AS. Factors associated with work outcomes were evaluated.Results: A total of 91 patients with mean age of 30 years old (87.8% males) and mean disease duration of 10 years received adalimumab treatment for 24 weeks. The annual estimated cost of each patient was $37581.41 while the direct cost accounted for 84.6%. Seventy-eight percent of patients have a paid job with average work productivity loss of 0.28 measured by work limitation questionnaire, absenteeism and presenteeism were 10.22 and 43.86%, respectively, with a mean work productivity loss of 47.92% measured by Work productivity and activity impairment questionnaire in AS. Patients experienced significantly greater improvements after adalimumab treatment in presenteeism, absenteeism, work productivity, and quality of life.Conclusions: The cost of AS patients with adalimumab therapy was high in China. Disease activity, physical function, quality of life, and work outcomes improved significantly after therapy.
Highlights
Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized with low back pain, morning stiffness, peripheral joints and extra-articular manifestations
Inclusion criteria includes fulfilling the 1984 modified New York criteria for AS, disease activity measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥4 after treated with at least 4 weeks’ full dose of non-steroidal anti-inflammatory drugs (NSAIDs)
There were significant differences in change of Ankylosing Spondylitis Quality of Life (ASQoL) and EQ-5D (change, −0.19 [95%CI, FIGURE 1 | (A–D) Disease activity and quality of life change before and after adalimumab treatment
Summary
Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized with low back pain, morning stiffness, peripheral joints and extra-articular manifestations. Adalimumab Work Outcomes Ankylosing Spondylitis burden for society. Work ability plays an important role in people’s daily life and is a core component of family income. International guidelines from the Canadian Rheumatology Association and the Spondyloarthritis Research Consortium of Canada recommended that work activities should be included as part of disease monitoring [3]. It has been reported that withdrawal from work and work instability were more common in AS patients than general population [4], even non-radiographic spondyloarthritis (SpA) patients experienced similar disease burden as [5]. In China, spark researches focus on the work ability and indirect cost of AS [6], many studies indicated that indirect cost including cost caused by work inability may contribute to a large scale of total cost [7]
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