Background Treatment with adalimumab (ADA) has been reported to improve work productivity and reduce indirect cost due to work impairment in patients with rheumatoid arthritis (RA). The impact of disease duration at the time of treatment initiation on work impairment is less well understood.
Objectives To assess the impact of disease duration before starting treatment with ADA on work productivity and economic benefit in Japanese patients with RA.
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 897 Japanese patients with RA receiving ADA.1 Patients were divided by quartiles (Q) based on disease duration at the time of ADA initiation. Work-related outcomes (absenteeism, presenteeism, overall work impairment [OWI], and activity impairment [AI]) were measured using the Work Productivity and Activity Impairment questionnaire for rheumatoid arthritis (WPAI/RA). Disease activity score based on 28 joint counts (DAS28) and the Health Assessment Questionnaire Disability Index (HAQ-DI) were used to assess clinical and functional response, respectively. For the comparison of changes in clinical response and WPAI domain scores by quartiles of disease duration, contrast test (linear trend) was performed with adjustments for baseline factors. Life saved productivity loss was estimated using OWI score and basic wages in Japanese workers 2012 by Ministry of Health Labor and Welfare.
Results At week 24, disease activity measures and WPAI/RA domain scores were significantly improved across quartiles. There were statistically significant decreasing trends in the percentage of patients achieving DAS28-ESR and HAQ-DI remission after 24 weeks of treatment with longer disease duration. Similarly, there were statistically significant decreasing trends in changes of OWI and AI (activity impairment) from baseline to week 24 with increasing disease duration (table). The estimated life saved productivity losses due to OWI for paid workers in this analysis were €88,292 for Q1, €61,541 for Q2, €55,677 for Q3 and €36,177 for Q4 (€1 = $1.40).
Conclusions Shorter disease duration before starting ADA treatment leads to better clinical response and work related outcomes in Japanese patients with RA. Earlier ADA treatment has an economic impact on lifetime benefit in Japanese RA patients.
Y. Tanaka, et al. ACR2013, Poster #2366
Acknowledgements This study was sponsored by AbbVie and Eisai Co., Ltd. AbbVie contributed to the study design, research, and interpretation of data, writing, reviewing, and approving the publication.
Disclosure of Interest T. Takeuchi Grant/research support: AbbVie GK., 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., 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, Speakers bureau: AbbVie GK., Bristol-Myers K.K., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., and Takeda Pharmaceutical Co., Ltd., Y. Shinmura Employee of: AbbVie GK, R. Nakajima Employee of: AbbVie GK, K. Hiramatsu Employee of: AbbVie GK, T. Kubo Employee of: AbbVie GK, A. Kimoto Employee of: AbbVie GK, A. Kuroki Employee of: AbbVie GK, A. Igarashi Grant/research support: TOWA Pharmaceutical Co., Ltd., Consultant for: Abbvie GK., Abbott Japan Co., Ltd., Boehringer Ingelheim Japan, Inc., Novartis Pharma K.K., and Pfizer Japan Inc., T. Tango Consultant for: AbbVie GK., Ajinomoto Pharma, Hospira Japan Co., Ltd., Y. Tanaka Grant/research support: Bristol-Myers, Mitsubishi-Tanabe, Abbvie, MSD, Chugai, Astellas, Daiichi-Sankyo, Consultant for: Mitsubishi-Tanabe, Eisai, Chugai, Abbott Japan, Astellas, Daiichi-Sankyo, Abbvie, Janssen, Pfizer, Takeda, Astra-Zeneca, Eli Lilly Japan, GlaxoSmithKline, Quintiles, MSD, Asahi-Kasei, Speakers bureau: Mitsubishi-Tanabe, Eisai, Chugai, Abbott Japan, Astellas, Daiichi-Sankyo, Abbvie, Janssen, Pfizer, Takeda, Astra-Zeneca, Eli Lilly Japan, GlaxoSmithKline, Quintiles, MSD, Asahi-Kasei