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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

Lookup NU author(s): Dr Lesley Kay

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Abstract

© 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.


Publication metadata

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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