Effect of anti-TNF and conventional synthetic disease-modifying anti-rheumatic drug treatment on work disability and clinical outcome in a multicentre observational cohort study of psoriatic arthritis. (26th December 2016)

• Record Type: Journal Article
• Authors: Tillett, William; Shaddick, Gavin; Jobling, Amelia; Askari, Ayman; Cooper, Annie; Creamer, Paul; Clunie, Gavin; Helliwell, Philip S.; James, Jana; Kay, Lesley; Korendowych, Eleanor; Lane, Suzanne; Packham, Jonathon; Shaban, Ragai; Thomas, Matthew L.; Williamson, Lyn; McHugh, Neil
• Is Part Of: Rheumatology. Volume 56:Number 4(2017)
• Page Start: 603
• Page End: 612
• Publication Date: 2016-12-26
• Subjects: psoriatic arthritis -- outcomes research -- csDMARDs -- anti-TNF -- work disability; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/kew433
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objective. To determine the effect of medical treatment on work disability in patients with active PsA in a real-world setting. Methods. Four hundred patients with active PsA commencing or switching to anti-TNF or conventional synthetic DMARD (csDMARD) were recruited to a multicentre UK prospective observational cohort study. Work disability was measured using the work productivity and activity-specific health problem instrument and peripheral joint activity was measured with the disease activity in PsA composite measure. Results. Four hundred patients were recruited, of whom 229 (57.25%) were working (of any age). Sixty-two patients of working age (24%) were unemployed. At 6 months there was a 10% improvement in presenteeism ( P = 0.007) and a 15% improvement in work productivity ( P = 0.001) among working patients commenced on csDMARDs ( n = 164) vs a larger and more rapid 30% improvement in presenteeism ( P < 0.001) and 40% improvement in work productivity ( P < 0.001) among those commenced on anti-TNF therapy ( n = 65). Clinical response was poor among patients commenced on a csDMARD ( n = 272), with an 8.4 point improvement in disease activity in PsA ( P < 0.001) vs those commenced on anti-TNF therapy ( n = 121), who had a 36.8 point improvement ( P < 0.001). Conclusion. We report significant and clinically meaningful improvements in both work disability and clinical outcomes after commencement of anti-TNF therapy in a real-world setting. Improvements in all outcomes among those commencing csDMARDs were slower and of a smaller magnitude.