Background Axial spondyloarthritis (axSpA) includes both ankylosing spondylitis (AS) and axSpA with no definitive sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA). AS significantly affects patients’ (pts) work productivity,¹ however, there is no evidence on the burden of axSpA or nr-axSpA on paid work and household productivity. RAPID-axSpA (NCT01087762) reports the efficacy and safety of certolizumab pegol (CZP) in axSpA pts.²

Objectives To estimate the economic burden of axSpA and compare directly AS and nr-axSpA in terms of workplace and household productivity losses.

Methods The ongoing 158-week (wk) RAPID-axSpA trial recruited pts with adult-onset active axSpA according to ASAS criteria,³ and included AS pts also meeting the mNY criteria and nr-axSpA pts. The impact of axSpA on workplace and household productivity was assessed at study baseline (BL), using the arthritis-specific Work Productivity Survey (WPS).⁴

Results At BL, disease activity was similar between AS and nr-axSpA pts but, as expected, symptom duration varied (9.1 vs 5.5 yrs). 69.2% of axSpA pts, 67.4% AS and 71.4% nr-axSpA, were employed outside the home. More AS vs nr-axSpA pts were unable to work due to spondyloarthritis (15.7% vs 8.2%). A high burden of axSpA on workplace and household productivity was reported with slightly higher burden in nr-axSpA vs AS (Table). On average, axSpA pts reported >1 wk of paid work and 2-3 wks of household duties or social activities affected/month. Household productivity losses were 2-3 times higher in non-employed and disease work disabled vs employed pts (Table). Employed pts with manual jobs reported higher losses at paid work and within household vs pts with non-manual jobs (Table). 39.1% of axSpA pts required regular assistance from relatives, friends or paid caregivers in their usual activities because of axSpA (42.1% in AS vs 35.4% in nr-axSpA). These pts reported higher workplace and household productivity losses vs those who did not require help (Table). Similar patterns were observed in AS and nr-axSpA.

Conclusions Similarly high burden of disease on workplace and household productivity was seen in AS and nr-axSpA pts that could lead to large financial burden for pts and society. Effective axSpA treatments are needed to prevent disability and work losses, and to reduce economic burden of the disease.

References

1. Boonen A. Ann Rheum Dis 2010;69:6 1123-1128;

2. Landewé R. Arthritis Rheum 2012;64(10): 336-337;

3. Rudwaleit M. Ann Rheum Dis 2009;68:6 770-776;

4. Osterhaus J. Arth Res Ther 2009;11(3):R73

Acknowledgements The authors acknowledge Costello Medical Consulting for writing and editorial assistance which was funded by UCB Pharma.

Disclosure of Interest D. van der Heijde Grant/research support from: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Consultant for: AbbVie, Amgen, AstraZeneca, BMS, Centocor, Chugai, Daiichi, Eli Lilly, GSK, Janssen, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex, Employee of: Imaging Rheumatology bv., O. Purcaru Employee of: UCB Pharma, A. Kavanaugh Grant/research support from: Abbott, Amgen, BMS, Pfizer, Roche, Janssen, UCB Pharma