RESEARCH - Effect of the early use of Humira on the prevention of job loss in patients with early RA

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Arthritis Rheum. 2008 Oct 15;59(10):1467-74.

Effect of the early use of the anti-tumor necrosis factor adalimumab

on the prevention of job loss in patients with early rheumatoid

arthritis.

Bejarano V, Quinn M, Conaghan PG, Reece R, Keenan AM, D, Gough

A, Green M, McGonagle D, Adebajo A, Jarrett S, Doherty S, Hordon L,

Melsom R, Unnebrink K, Kupper H, Emery P; Yorkshire Early Arthritis

Register Consortium.

University of Leeds, Leeds, UK.

OBJECTIVE: To compare work disability and job loss in early rheumatoid

arthritis (RA) patients receiving adalimumab plus methotrexate

(adalimumab + MTX) versus MTX alone.

METHODS: In this multicenter, randomized, controlled trial, patients

with RA for <2 years who had never taken MTX and who self-reported

work impairment were randomized to adalimumab + MTX or placebo + MTX

for 56 weeks. Primary outcome was job loss of any cause and/or

imminent job loss at or after week 16. Secondary outcomes included

disease activity, function (Health Assessment Questionnaire [HAQ]

score), and RA quality of life (RAQoL) questionnaire score. Work was

evaluated with work diaries and the RA Work Instability Scale.

RESULTS: Although job loss during the 56-week study was significantly

lower with adalimumab + MTX (14 of 75 patients) compared with MTX

alone (29 of 73 patients; P = 0.005), the primary end point was not

met (12 of 75 versus 20 of 73 patients; P = 0.092), likely owing to

early drop out in the MTX group. There were significant improvements

in American College of Rheumatology 20% response criteria, 28-joint

Disease Activity Score, DeltaHAQ, DeltaRAQoL, and working time lost in

the adalimumab + MTX group. Twenty-four serious adverse events were

reported in 17 participants, with no differences between groups.

CONCLUSION: Adalimumab + MTX reduced job loss and improved

productivity in early RA when compared with MTX alone, which supports

the early use of anti-tumor necrosis factor therapy and suggests its

cost efficacy.

PMID: 18821658

http://www.ncbi.nlm.nih.gov/pubmed/18821658

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