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

William Tillett, Gavin Shaddick, Amelia Jobling, Ayman Askari, Annie Cooper, Paul Creamer, Gavin Clunie, Philip S Helliwell, Jana James, Lesley Kay, Eleanor Korendowych, Suzanne Lane, Jonathon Packham, Ragai Shaban, Matthew L Thomas, Lyn Williamson, Neil McHugh

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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.

Original languageEnglish
Pages (from-to)603-612
JournalRheumatology
Volume56
Issue number4
Early online date24 Dec 2016
DOIs
Publication statusPublished - 1 Apr 2017

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Psoriatic Arthritis
Antirheumatic Agents
Observational Studies
Cohort Studies
Efficiency
Therapeutics
Health

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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. / 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.

In: Rheumatology, Vol. 56, No. 4, 01.04.2017, p. 603-612.

Research output: Contribution to journalArticle

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. / 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. In: Rheumatology. 2017 ; Vol. 56, No. 4. pp. 603-612.
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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.",
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TY - JOUR

T1 - 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

AU - Tillett, William

AU - Shaddick, Gavin

AU - Jobling, Amelia

AU - Askari, Ayman

AU - Cooper, Annie

AU - Creamer, Paul

AU - Clunie, Gavin

AU - Helliwell, Philip S

AU - James, Jana

AU - Kay, Lesley

AU - Korendowych, Eleanor

AU - Lane, Suzanne

AU - Packham, Jonathon

AU - Shaban, Ragai

AU - Thomas, Matthew L

AU - Williamson, Lyn

AU - McHugh, Neil

N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - 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.

AB - 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.

UR - https://doi.org/10.1093/rheumatology/kew433

U2 - 10.1093/rheumatology/kew433

DO - 10.1093/rheumatology/kew433

M3 - Article

VL - 56

SP - 603

EP - 612

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 4

ER -