Background Previous studies have examined the overall burden of RA on patients' HRQoL and work productivity. However, a gap still exists in understanding how this burden varies by RA disease activity and severity in the real-world.
Objectives To examine the real-world differences in the burden of RA on patients' HRQoL and work productivity using validated instruments by levels of disease activity.
Methods Patients with confirmed RA aged ≥21 years were recruited in a multinational (Netherlands, Canada, and US), observational, longitudinal study – the Patient Reported Outcomes Survey in Employment among patients with RA (PROSE-RA). Patients self-reported all data via web-surveys at baseline and months 3, 6, 9 and 12. HRQoL was measured using the short form (SF)-36, estimating the Physical Component Score (PCS) and Mental Component Score (MCS). Work productivity was measured using the Work Productivity and Activity Impairment questionnaire, estimating the percentage of overall work impairment (absenteeism + presenteeism) in only the employed patients and overall regular activities impairment in all patients. RA disease activity was categorized into four classes using the Routine Assessment of Patient Index Data (RAPID3) scores: remission (≤3), low (3.1-6), moderate (6.1-12) and high (>12). Data on patients' sociodemographics and clinical characteristics were also collected. Only baseline data from PROSE-RA were used in the current study. Using the overall work impairment, regular activities impairment, PCS, and MCS as the dependent variables, separate multiple linear regression models were built to determine their associations with disease activity after adjusting for age, gender, education, duration of RA, comorbidities, and medication utilization.
Results A total of 237 patients were evaluated, of which 39.7% (n=94) were in high, 30.4% (n=72) moderate, 13.5% (n=32) low, and 16.5% (n=39) remission disease activity. Overall, the mean age was 52.1±11.9 years, 76.7% (n=182) were females, 53.2% (n=126) were employed, and 70.3% (n=167) were married. In univariate analysis, the mean ± SD percentage of overall work impairment and regular activities impairment varied significantly (p<0.05) according to the four disease activity levels: 5.5±5.1, 14.8±16.2, 26.6±3.2, 52.5±24.5 and 7.1±9.0, 20.0±16.5, 33.±17.73, 60.95±23.19, respectively. Also, both the PCS and MCS varied significantly with disease activity: 52.98±5.31, 45.22±5.46, 38.97±6.72, 30.29±7.71 and 52.50±8.44, 53.69±7.30, 50.87±8.52, 45.14±11.67, respectively. In multivariate analysis, disease activity was independently associated with overall work impairment, regular activities impairment, PCS, and MCS (Table 1).
Conclusions Using RAPID3 – a feasible index to measure RA disease activity in busy clinical settings – the real-world burden of RA on work productivity and HRQoL was found to increase with RA disease activity. Even patients with lower disease activity experience a substantial burden of RA illness.
Bansback N, et al. Rheumatology. 2012;51:375-384.
Disclosure of Interest : A. Boonen Grant/research support: Amgen, AbbVie, Merck, Pfizer, Speakers bureau: UCB, Pfizer, A. Kavanaugh Grant/research support: AbbVie, W. Maksymowych Grant/research support: AbbVie, A. Ganguli Shareholder of: AbbVie, Employee of: AbbVie, Y. Jalundhwala Employee of: Former employee: AbbVie, C. Bao Shareholder of: AbbVie, Employee of: AbbVie, V. Garg Shareholder of: AbbVie, Employee of: AbbVie, M. Bergman Shareholder of: Pfizer, Merck, Grant/research support: AbbVie, BMS, Genentech, Consultant for: AbbVie, Genentech, Pfizer, Celgene, Speakers bureau: AbbVie, UCB, BMS