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 ORCID: https://orcid.org/0000-0002-4117-4264, 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 and McHugh, Neil 2017. 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. Rheumatology 56 (4) , pp. 603-612. 10.1093/rheumatology/kew433

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	?? VCO ??
Publisher:	Oxford University Press
ISSN:	1462-0324
Last Modified:	30 Jul 2024 15:02
URI:	https://orca.cardiff.ac.uk/id/eprint/170797

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