Background Rheumatoid arthritis (RA) significantly impairs work productivity and daily activities, for which therapeutic approaches have still to be investigated.
Objectives To examine the effectiveness of adalimumab (ADA) with respect to RA-related work productivity and activity impairment, as well as associations between changes in work outcomes and changes in disease activity, in Japanese patients with different employment statuses. The first 24-week interim results from the 48-week, multicenter, prospective, single-cohort observational study of self-reported work productivity and activity impairment (ANOUVAEU study) were presented at EULAR in 2013, and here we report the final 48-week results from the study.
Methods Data were obtained from 1973 Japanese RA patients enrolled in the ANOUVAEU study. Work-related outcomes were measured using the Work Productivity and Activity Impairment questionnaire for RA (WPAI/RA), including employment status [paid-worker (employed for ≥35 hr/week), home-worker (employed for <35 hr/week) or non-employed], absenteeism (work time missed), presenteeism (impairment while working), overall work impairment (OWI) and 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 were used to assess clinical response. Factors associated with improvement of WPAI/RA domain scores were analyzed by multivariate analysis, and correlations between changes in WPAI/RA domain scores and clinical responses were estimated.
Results Overall, absenteeism, presenteeism, OWI and AI scores were significantly improved by treatment with ADA, and the observed improvements at week 24 were sustained until week 48 (Table). HAQ-DI and EQ-5D were also consistently improved from week 12 until week 48 (p<0.0001). In parallel with these improvements, the clinical remission rate as determined by DAS28-CRP significantly increased from 9.0% at baseline to 32.5% at week 12 and 41.1% at week 48 (p<0.0001). Additional results including factors associated with improvement of WPAI/RA domain scores and correlations between changes in WPAI/RA domain scores and clinical responses will be discussed.
Conclusions ADA demonstrated significant sustained improvements in RA-related work productivity and activity impairment in Japanese RA patients. Treatment with ADA for RA patients may reduce their potential risks of becoming unemployed and financially impaired.
Disclosure of Interest T. Takeuchi Grant/research support from: AbbVie GK, Astellas Pharma, Bristol-Myers K.K., Chugai Pharmaceutical Co., Daiichi Sankyo, Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, Nippon Shinyaku Co., Ltd., Pfizer Japan Inc., Sanofi K.K., Santen Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company, and Teijin Pharma Limited, Consultant for: AstraZeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Corporation, and Asahi Kasei Medical Co., Ltd, Speakers bureau: AbbVie GK, Bristol-Myers Squibb K.K., Chugai Pharmaceutical Co., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, Pfizer Japan Inc., and Takeda Pharmaceutical Company, R. Nakajima Employee of: AbbVie GK, N. Agata Employee of: AbbVie GK, Y. Tanaka Grant/research support from: Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, Taisho-Toyama, Kyowa-Kirin, Abbvie, Bristol-Myers, Consultant for: Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-Kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, Santen