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Lookup NU author(s): Dr Lesley Kay
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© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. 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). Sixtytwo 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.
Author(s): Tillett W, Shaddick G, Jobling A, Askari A, Cooper A, Creamer P, Clunie G, Helliwell PS, James J, Kay L, Korendowych E, Lane S, Packham J, Shaban R, Thomas ML, Williamson L, McHugh N
Publication type: Article
Publication status: Published
Journal: Rheumatology
Year: 2017
Volume: 56
Issue: 4
Pages: 603-612
Print publication date: 01/04/2017
Online publication date: 26/12/2016
Acceptance date: 24/10/2016
ISSN (print): 1462-0324
ISSN (electronic): 1462-0332
Publisher: Oxford University Press
URL: https://doi.org/10.1093/rheumatology/kew433
DOI: 10.1093/rheumatology/kew433
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