Background Axial spondyloarthritis (axSpA) includes both ankylosing spondylitis (AS) and axSpA with no definitive sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA). AS significantly affects patients’ (pts) work productivity.1 The impact of the entire spectrum of axSpA on work productivity is still poorly researched. RAPID-axSpA (NCT01087762) investigated the efficacy and safety of certolizumab pegol (CZP), a PEGylated Fc-free anti-TNF, in axSpA pts.
Objectives To report the effect of CZP on paid and household work productivity, and daily activities, in axSpA pts, including pts with AS and nr-axSpA.
Methods The ongoing 158-week (wk) Phase 3 RAPID-axSpA trial is double-blind and placebo (PBO)-controlled to Wk24.2 Recruited pts had adult-onset active axSpA according to the ASAS criteria,3 and included AS pts also meeting the modified New York criteria and nr-axSpA pts.2 Pts were randomized 1:1:1 to PBO every 2 wks (Q2W), or CZP 400mg at Wk0, 2 and 4 (loading dose) followed by either CZP 200mg Q2W or CZP 400mg every 4 wks (Q4W). The arthritis-specific Work Productivity Survey (WPS, administered Q4W) assessed the impact of axSpA on workplace and household productivity. WPS responses (LOCF imputation) were compared between treatment arms of the full analysis set (FAS) using a non-parametric bootstrap-t method.
Results 325 pts were randomized. 63.2%, 69.4%, and 74.8% of pts in the PBO, CZP 200mg Q2W, and CZP 400mg Q4W treatment groups were employed at baseline (BL). Workplace and household productivity were comparable between treatment groups at BL. At BL the burden of axSpA on absenteeism, presenteeism, household productivity and social activities was high (Table). At Wk24, compared to PBO, employed pts in both CZP groups reported reduced absenteeism and presenteeism (Table), and reduced axSpA interference with work. CZP groups also reported greater reductions vs PBO in days lost of household work and of family/social/leisure activities per month, days with reduced household productivity (Table) and in axSpA interference with household duties. Workplace and household productivity improvements were observed as early as Wk4, and in both AS and nr-axSpA pts.
Conclusions CZP improved workplace productivity in pts with axSpA by reducing absenteeism, presenteeism and axSpA interference with work. CZP also improved household productivity and increased participation in social and daily activities. Similar improvements were observed in AS and nr-axSpA populations.
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Acknowledgements The authors acknowledge Costello Medical Consulting for writing and editorial assistance which was funded by UCB Pharma.
Disclosure of Interest D. van der Heijde Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Employee of: Imaging Rheumatology bv., J. Braun Grant/research support from: Abbott, BMS, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Consultant for: Abbott, BMS, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, M. Rudwaleit Consultant for: Abbott, BMS, MSD, Pfizer, Roche, UCB Pharma, O. Purcaru Employee of: UCB Pharma, A. Kavanaugh Grant/research support from: Abbott, Amgen, BMS, Pfizer, Roche, Janssen, UCB Pharma