Background Axial spondyloarthritis (axSpA) includes patients (pts) with both ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA).1 AS significantly affects pt workplace productivity, both in terms of performance and disease-related absenteeism.2 By contrast, the impact of nr-axSpA on productivity is less well characterized. Furthermore, there are few studies on the association between improvements in workplace and household productivity and symptom relief with available therapies in axSpA pts.
Objectives To evaluate the association between improvements in clinical and pt-reported outcomes (PROs) and improvements in productivity in the workplace and at home in axSpA pts treated with certolizumab pegol (CZP), including AS and nr-axSpA pts.
Methods Associations between clinical outcomes or PROs and work and household productivity outcomes were made using Wk24 data from the double-blind and placebo-controlled period of RAPID-axSpA (NCT01087762),3 for pts originally randomized to CZP. Clinical outcomes included achievement of ASAS40 and ASDAS MI responses. PROs included achievement of MCID for BASFI (≥1 decrease from baseline [BL]), total back pain (≥1 decrease from BL) and ASQoL (≥2 decrease from BL). Responders and non-responders at Wk24 for clinical outcomes and PROs were compared in terms of change from BL (CFB) in workplace and household productivity, as assessed using the validated arthritis-specific Work Productivity Survey (WPS).4 Groups were compared using a non-parametric bootstrap-t method. Missing data were imputed using last observation carried forward for WPS outcomes and non-responder imputation for clinical outcomes and PROs.
Results 218 CZP pts entering RAPID-axSpA were included in Wk24 analyses, including 121 AS and 97 nr-axSpA pts. 73.9% axSpA, 73.6% AS and 74.2% nr-axSpA pts were employed at Wk24. Overall, pts achieving a clinical or PRO response at Wk24 reported greater improvements in workplace and household productivity than non-responders (Table). Improvements in ASQoL and clinically meaningful reductions in functional limitation and pain were associated with improved workplace absenteeism and presenteeism. Greater improvements in productivity were seen in responders vs non-responders in both AS and nr-axSpA subpopulations. Numerically greater CFB was seen in nr-axSpA pts, potentially due to the slightly higher BL productivity burden of nr-axSpA vs AS.5 Responders also reported greater improvements in participation in family, social and leisure activities (not shown). Results should be interpreted with caution, due to differences in the number of pts between groups and because analyses were not adjusted for differences in BL productivity.
Conclusions Clinical responses and clinically meaningful improvements in PROs are associated with improved workplace and household productivity in axSpA pts treated with CZP, including both AS and nr-axSpA pts.
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Disclosure of Interest D. van der Heijde Grant/research support from: AbbVie, Amgen, AstraZeneca, Augurex, BMS, Boehringer Ingelheim, Celgene, Centocor, Chugai, Covagen, Daiichi, Eli-Lilly, Galapagos, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, UCB Pharma, Vertex, Consultant for: AbbVie, Amgen, AstraZeneca, Augurex, BMS, Boehringer Ingelheim, Celgene, Centocor, Chugai, Covagen, Daiichi, Eli-Lilly, Galapagos, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, UCB Pharma, Vertex, Employee of: Director of Imaging Rheumatology bv, J. Braun Grant/research support from: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Consultant for: Abbott, Bristol Myers Squibb, 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