Background Rheumatoid arthritis (RA) significantly impairs work productivity and daily activities.
Objectives To examine the effectiveness of adalimumab (ADA) with respect to RA-related work productivity and activity impairment, as well as associations of changes in work outcomes with changes in disease activity, in Japanese patients with different employment statuses.
Methods Data were taken from the first 24 weeks of a 48-week, multicenter, prospective, single-cohort study of self-reported work productivity and activity impairment in 475 Japanese patients with RA receiving ADA. Work-related outcomes were measured using the Work Productivity and Activity Impairment questionnaire for rheumatoid arthritis (WPAI/RA), including employment status (paid-worker [PW] employed for ≥35hr/week, n=145, home-worker [HW] employed for <35hr/week, or non-employed, n=330), absenteeism (percent work time missed due to RA), presenteeism (percent impairment while working due to RA), percent overall work impairment (OWI) due to RA, and percent activity impairment (AI) due to RA. The Health Assessment Questionnaire Disability Index (HAQ-DI), EQ-5D, disease activity score based on 28 joint count (DAS28), Clinical Disease Activity Index, and Simplified Disease Activity Index (SDAI) were used to assess clinical response. Correlations between changes in WPAI/RA domain scores and clinical responses at 24 weeks were estimated.
Results At week 24, presenteeism, OWI and AI scores were significantly improved, and there were strong correlations between changes in WPAI/RA domain scores and measures of clinical response (Table). Improvements in WPAI/RA presenteeism, OWI and AI scores tended to be greatest among patients who were bio-naïve, treated with methotrexate at a dose of ≥10mg/week, had early RA (≤2 years), and were <50 years of age. Interestingly, PWs responded to ADA earlier than HWs. Approximately, 40% of PWs achieved clinical remission (DAS28 <2.6) at 12 weeks that was sustained through 24 weeks after initiating ADA. In contrast, only 20% of HWs achieved clinical remission at week 12. Mean DAS28 scores at baseline were comparable for the two groups of patients.
Conclusions Treatment with ADA is associated with improvements in RA-related work productivity and activity impairment in Japanese patients with RA. Early response to ADA may allow PWs to maintain their employment status.
Disclosure of Interest: T. Takeuchi Grant/research support from: Abbott Japan Co., Ltd., Astellas Pharma, Bristol-Myers K.K., Chugai Pharmaceutical Co, Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Nippon Shinyaku Co., Ltd., Otsuka Pharmaceutical, Pfizer Japan Inc., Sanofi-Aventis K.K., Santen Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd., Consultant for: Astra Zeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Co., and Asahi Kasei Medical K.K, S. Komatsu Employee of: AbbVie GK, T. Muramatsu Employee of: AbbVie GK, T. Kubo Employee of: AbbVie GK, A. Kuroki Employee of: AbbVie GK, T. Tango Consultant for: Abbott Japan Co. Ltd., Ajinomoto Pharma, Hospira Japan Co., Ltd., Y. Tanaka Grant/research support from: Bristol-Myers Squibb, MSD K.K., Chugai Pharmaceutical Co., Ltd., Mitsubishi-Tanabe Pharma Corporation, Astellas Pharma Inc., Abbott Japan Co., Ltd., Eisai Co., Ltd. and Janssen Pharmaceutical K.K, Consultant for: Mitsubishi-Tanabe Pharma Corporation, Abbott Japan Co., Ltd., Eisai Co., Ltd., Chugai Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Santen Pharmaceutical Co., Ltd., Pfizer Japan Inc., Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., GlaxoSmithKline K.K., Astra-Zeneca, Otsuka Pharmaceutical Co., Ltd., Actelion Pharmaceuticals Japan Ltd., Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., UCB Japan Co., Ltd., Quintiles Transnational Japan Co., Ltd., Ono Pharmaceutical Co., Ltd., and Novartis Pharma K.K.