PBI6 Stringent Thresholds of Disease Control Are Associated with Reduced Burden on Paid and Household Work Productivity in Patients with Psoriatic Arthritis during LONG-TERM Treatment with Certolizumab Pegol

Abstract

To evaluate the association between improvements in clinical outcomes and burden on work productivity in psoriatic arthritis (PsA) patients during long-term treatment with certolizumab pegol (CZP). Analyses used data from patients originally randomised to CZP in RAPID-PsA (NCT01087788), a 216-week phase 3 study.1 Responders and non-responders of American College of Rheumatology (ACR) 20/50/70 criteria were compared in terms of paid work and household productivity, assessed with the arthritis-specific Work Productivity Survey. An inverse probability weight model was used to account for predictors of dropout over 216 weeks. Cumulative days missed since study baseline were estimated using a weighted generalised estimating equations model. 273 patients were randomised to CZP, 183 (67.0%) of whom completed Week 216. At baseline, 60.8% of patients were employed outside the home. Through Week 216, fewer paid work days missed due to arthritis (absenteeism) were associated with stringent disease activity thresholds: non-response, 35.7 (95% confidence interval, 17.9–53.5); ACR20 to <50, 20.9 (9.2–32.6); ACR50 to <70, 7.7 (3.2–12.1); ACR70, 4.1 (0.4–7.9). Stringent levels of disease control were also associated with fewer days of reduced workplace productivity (presenteeism): non-response, 141.2 (64.0–218.3); ACR20 to <50, 71.2 (32.4–110.0); ACR50 to <70, 19.3 (11.3–27.3); ACR70, 5.6 (2.0–9.2). Patients achieving stringent ACR thresholds also reported fewer days of household work absenteeism: non-response, 189.9 (129.1–250.7); ACR20 to <50, 124.0 (80.0–168.1); ACR50 to <70, 71.6 (16.5–126.8); ACR70, 8.5 (4.4–12.5), and presenteeism: non-response, 244.1 (177.4–310.7); ACR20 to <50, 144.5 (109.0–180.0); ACR50 to <70, 105.8 (56.3–155.2); ACR70, 20.3 (6.5–34.0). Over four years of CZP treatment, achievement of increasingly stringent thresholds of disease control in patients with PsA was associated with decreased burden on paid and household work productivity. 1. van der Heijde D. et al. RMD Open 2018;4:e000582.