Background Ankylosing spondylitis (RS) is chronic inflammatory disease that causes inflammation of the joints between the spinal bones, and the joints between the spine and pelvis. It eventually causes the affected spinal bones to join together. Tumor necrosis factor (TNF) has been implicated in a number of arthritic disease states, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Adalimumab is the first fully human, high-affinity, recombinant immunoglobulin G1 (IgG1) anti-TNF monoclonal antibody.
Objectives To determine whether treatment with Adalimumab improves disease activity, occupational outcomes and increases work productivity in patients with ankylosing spondylitis (AS).
Methods During 2009-2011, 178 patients with confirmld diagnosis AS were included in the study. 82.79% were male and 17.21% female, aged 20-75 (mean 42) years. Patients were divided in two subgroups due to disease activity, first group with moderate disease activity (BASDAI 4-7) and second group with severe disease activity (BASDAI 8-10). Patients were treated with Adalimumab for at least 6 months.Changes in functional status and disease activity were assessed using the Bath ASDisease Activity Index (BASDAI), Visual Analog Scale(VAS)and Work Productivity and ActivityImpairment questionnaire in AS (WPAI:SpA). The results were analyzed with regression analysis ANOVA on SPSS.
Results Patients with severe activity of AS showed significantly greater reduction of BASDAI score than patients with moderate disease activity(3.4 vs. 1.9) p. Of the 178 patients included in this study, 145 (81.46%) showed clinical response (reduction of BASDAI score by at least 2 points). Clinical responders had significant improvement in work productivity, workday loss and daily activity impairment according to WPAI-SHP scores (presenteeism -21.1, p=0.04; overall work impairment -22.2, p=0.04; daily activity impairment -24.4, p
Conclusions Disease activity in patients with AS determine patient’s ability to work. Patients treated with Adalimumab and responded to the treatment had significant reduction in limitations of work and daily activity. Treatment with Adalimumab significantly reduce workday loss among employed patients with AS.
[AB] Abbott Laboratories Press Releases. Abbott announces US and EU regulatory submissions seeking approval of Humira® (adalimumab in ankylosing spondylitis (AS) 2005. Oct 4, Accessed 3 April 2006.
Maksymowych WP, Gooch KL, Wong RL, Kupper H, van der Heijde D: Impact of age, sex, physical function, health-related quality of life, and treatment with adalimumab on work status and work productivity of patients with ankylosing spondylitis. J Rheumatol 2010, 37:385-392
Keat AC, Gaffney K, Gilbert AK, Harris C, Leeder J: Influence of biologic therapy on return to work in people with work disability due to ankylosing spondylitis. Rheumatology (Oxford) 2008, 47:481-483.
van der Heijde DM, Revicki DA, Gooch KL, Wong RL, Kupper H, Harnam N, Thompson C, Sieper J: Physical function, disease activity, and health-related quality-of-life outcomes after 3 years of adalimumab treatment in patients with ankylosing spondylitis. Arthritis Res Ther 2009, 11:R124.
Disclosure of Interest None Declared
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