Sustained improvement in work outcomes in employed patients with rheumatoid arthritis during 2\xa0years of adalimumab therapy: an observational cohort study

Frank Behrens,Marc Schmalzing,Michaela Koehm,Holger Gnann,Gerd Greger,Eva C Schwaneck,Harald Burkhardt,Hans-Peter Tony

doi:10.1007/s10067-020-05038-y

Abstract

ObjectiveThe goal of this study was to evaluate the long-term impact of adalimumab therapy on work-related outcomes in employed patients with rheumatoid arthritis (RA).MethodWe utilized data from an observational cohort of German patients who initiated adalimumab treatment during routine clinical care. Analyses were based on employed patients (part-time or full-time) who continued adalimumab treatment for 24 months. Major outcomes were self-reported sick leave days in the previous 6 months, absenteeism, presenteeism, and total work productivity impairment as assessed by the Work Productivity and Activity Impairment (WPAI) questionnaire and disease activity assessments. The normal number of sick leave days was based on data from the German Federal Statistical Office.ResultsOf 783 patients, 72.3% were women, mean age was 47.9 years, and mean disease duration was 7.8 years. At baseline (before adalimumab initiation), 42.9% of patients had higher than normal sick leave days (> 5) in the previous 6 months. During 24 months of adalimumab treatment, 61% of patients with higher than normal sick leave days at baseline returned to normal sick leave values (≤ 5 days/6 months). Overall, mean sick leave days/6 months decreased from 14.8 days at baseline to 7.4 days at month 24. Improvements were observed in WPAI assessments and disease activity measures, although presenteeism levels remained high (32.2% at month 24).ConclusionsAdalimumab treatment was associated with strong and sustained improvements in work-related outcomes in employed patients who continued on adalimumab for 24 months. Presenteeism appears to be the work outcome most resistant to improvement during RA treatment.Trial registrationNCT01076205Key Points• Long-term adalimumab therapy was associated with sustained improvements in work outcomes in patients with rheumatoid arthritis.• Despite improvements in sick leave days and work absenteeism, presenteeism (impairment while at work) remained relatively high.

Highlights

Rheumatoid arthritis (RA) is characterized by joint destruction and reductions in function and patient well-being [1], which can result in the reduced ability to engage in productive work [2,3,4]
We used data from a large observational study to explore the impact of 24 months of adalimumab therapy on sick leave days and work productivity in employed patients with RA during routine clinical care in Germany
This study utilized data from German patients with RA enrolled in a multicenter observational trial who received adalimumab therapy at the decision of the clinician (Clinicaltrials.gov trial registration NCT01076205)

Summary

Introduction

Rheumatoid arthritis (RA) is characterized by joint destruction and reductions in function and patient well-being [1], which can result in the reduced ability to engage in productive work [2,3,4]. Recent studies on the effect of therapeutic intervention on work productivity have examined work-related outcomes over a period of 6 to 12 months [11,12,13,14,15] or have focused on patients with specific characteristics, such as early RA [13, 14, 16]. We used data from a large observational study to explore the impact of 24 months of adalimumab therapy on sick leave days and work productivity in employed patients with RA during routine clinical care in Germany

Methods

Results

Conclusion