RESEARCH - Impact of Humira on work participation in RA

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Ann Rheum Dis. 2008 Oct 1.

Impact of adalimumab on work participation in rheumatoid arthritis:

comparison of an open-label extension study and a registry-based

control group.

Halpern MT, Cifaldi MA, Kvien TK.

Emory University, United States.

OBJECTIVES: Rheumatoid arthritis (RA) causes significant disability

and often results in loss of work capacity and productivity. We

evaluated the impact of adalimumab, a tumour necrosis factor

antagonist with demonstrated efficacy in RA, on long-term employment.

METHODS: Data from an open-label extension study (DE033) of 486 RA

patients receiving adalimumab monotherapy who previously failed at

least 1 disease-modifying antirheumatic drug (DMARD) and had baseline

work status information were compared with data from 747 RA patients

receiving DMARD therapy in a Norway-based longitudinal registry.

Primary outcomes included the time patients continued working at least

part-time and the likelihood of stopping work. Secondary outcomes

included American College of Rheumatology (ACR) and EULAR responses

and disease remission. Outcomes were compared 6, 12, and 24 months

after enrollment.

RESULTS: During a 24-month period, the 158 adalimumab-treated patients

who were working at baseline worked 7.32 months longer (95% confidence

interval [CI]: 4.8, 9.1) than did the 180 DMARD-treated patients,

controlling for differences in baseline characteristics. Regardless of

baseline work status, patients receiving adalimumab worked 2.0 months

longer (95% CI: 1.3, 2.6) and were significantly less likely to stop

working (hazard ratio

---

, 0.36, 95% CI: -0.30, 0.42] for all

patients and 0.36, 95% CI: 0.15, 0.85] for patients working at

baseline, respectively) than those receiving DMARDs.

Adalimumab-treated patients also were significantly more likely to

achieve ACR responses and disease remission than DMARD-treated

patients. Patients who achieved EULAR good response and remission were

less likely to stop working, but this relationship was only seen in in

patients receiving DMARDs.

CONCLUSIONS: Patients with RA receiving adalimumab experienced

significantly longer periods of work and continuous employment, as

well as greater rates of clinical responses, than did those receiving

DMARDs. The mechanism by which adalimumab decreases likelihood of

stopping work appears different from that of DMARD therapy and

independent of clinical responses.

PMID: 18829616

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Read the entire article here:

http://ard.bmj.com/cgi/rapidpdf/ard.2008.092734v1

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