Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group
Identifieur interne : 000044 ( Ncbi/Merge ); précédent : 000043; suivant : 000045Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group
Auteurs : M T Halpern [États-Unis] ; M A Cifaldi [États-Unis] ; T K Kvien [Norvège]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2008.
Abstract
Rheumatoid arthritis (RA) causes considerable disability and often results in loss of work capacity and productivity. This study evaluated the impact of adalimumab, a tumour necrosis factor antagonist with demonstrated efficacy in RA, on long-term employment.
Data from an open-label extension study (DE033) of 486 RA patients receiving adalimumab monotherapy who previously did not respond to at least one disease-modifying antirheumatic drug (DMARD) and had baseline work status information were compared with data from 747 RA patients receiving DMARD treatment in a Norway-based longitudinal registry. Primary outcomes included the time patients continued working at least part time and the likelihood of stopping work. Secondary outcomes included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) responses and disease remission. Outcomes were compared 6, 12 and 24 months after enrolment.
During a 24-month period, the 158 patients who received adalimumab and were working at baseline worked 7.32 months longer (95% CI 4.8 to 9.1) than did the 180 patients treated with DMARDs, controlling for differences in baseline characteristics. Regardless of baseline work status, patients receiving adalimumab worked 2.0 months longer (95% CI 1.3 to 2.6) and were significantly less likely to stop working than those receiving DMARDs (HR 0.36 (95% CI −0.30 to 0.42) for all patients and 0.36 (95% CI 0.15 to 0.85) for patients working at baseline, respectively). The patients who received adalimumab were also considerably more likely to achieve ACR responses and disease remission than DMARD-treated patients. Patients who achieved EULAR good response and remission were less likely to stop working, but this relationship was only seen in patients receiving DMARDs.
Patients with RA who received adalimumab experienced considerably longer periods of work and continuous employment, and greater rates of clinical responses, than patients receiving DMARDs. The mechanism by which adalimumab decreases likelihood of stopping work seems to be different from that of DMARD treatment and independent of clinical responses.
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DOI: 10.1136/ard.2008.092734
PubMed: 18829616
PubMed Central: 2674552
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group</title><author><name sortKey="Halpern, M T" sort="Halpern, M T" uniqKey="Halpern M" first="M T" last="Halpern">M T Halpern</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Department of Health Policy and Management, Emory University, Atlanta, Georgia, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Management, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Cifaldi, M A" sort="Cifaldi, M A" uniqKey="Cifaldi M" first="M A" last="Cifaldi">M A Cifaldi</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, Illinois, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T K" last="Kvien">T K Kvien</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, and Faculty of Medicine, University of Oslo, Oslo, Norway</addr-line></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, and Faculty of Medicine, University of Oslo, Oslo</wicri:regionArea><wicri:noRegion>Oslo</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18829616</idno><idno type="pmc">2674552</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674552</idno><idno type="RBID">PMC:2674552</idno><idno type="doi">10.1136/ard.2008.092734</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000320</idno><idno type="wicri:Area/Pmc/Curation">000320</idno><idno type="wicri:Area/Pmc/Checkpoint">000421</idno><idno type="wicri:Area/Ncbi/Merge">000044</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group</title><author><name sortKey="Halpern, M T" sort="Halpern, M T" uniqKey="Halpern M" first="M T" last="Halpern">M T Halpern</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Department of Health Policy and Management, Emory University, Atlanta, Georgia, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Policy and Management, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Cifaldi, M A" sort="Cifaldi, M A" uniqKey="Cifaldi M" first="M A" last="Cifaldi">M A Cifaldi</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, Illinois, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T K" last="Kvien">T K Kvien</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, and Faculty of Medicine, University of Oslo, Oslo, Norway</addr-line></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, and Faculty of Medicine, University of Oslo, Oslo</wicri:regionArea><wicri:noRegion>Oslo</wicri:noRegion></affiliation></author></analytic><series><title level="j">Annals of the Rheumatic Diseases</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background and objectives:</title><p>Rheumatoid arthritis (RA) causes considerable disability and often results in loss of work capacity and productivity. This study evaluated the impact of adalimumab, a tumour necrosis factor antagonist with demonstrated efficacy in RA, on long-term employment.</p></sec><sec><title>Methods:</title><p>Data from an open-label extension study (DE033) of 486 RA patients receiving adalimumab monotherapy who previously did not respond to at least one disease-modifying antirheumatic drug (DMARD) and had baseline work status information were compared with data from 747 RA patients receiving DMARD treatment in a Norway-based longitudinal registry. Primary outcomes included the time patients continued working at least part time and the likelihood of stopping work. Secondary outcomes included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) responses and disease remission. Outcomes were compared 6, 12 and 24 months after enrolment.</p></sec><sec><title>Results:</title><p>During a 24-month period, the 158 patients who received adalimumab and were working at baseline worked 7.32 months longer (95% CI 4.8 to 9.1) than did the 180 patients treated with DMARDs, controlling for differences in baseline characteristics. Regardless of baseline work status, patients receiving adalimumab worked 2.0 months longer (95% CI 1.3 to 2.6) and were significantly less likely to stop working than those receiving DMARDs (HR 0.36 (95% CI −0.30 to 0.42) for all patients and 0.36 (95% CI 0.15 to 0.85) for patients working at baseline, respectively). The patients who received adalimumab were also considerably more likely to achieve ACR responses and disease remission than DMARD-treated patients. Patients who achieved EULAR good response and remission were less likely to stop working, but this relationship was only seen in patients receiving DMARDs.</p></sec><sec><title>Conclusions:</title><p>Patients with RA who received adalimumab experienced considerably longer periods of work and continuous employment, and greater rates of clinical responses, than patients receiving DMARDs. The mechanism by which adalimumab decreases likelihood of stopping work seems to be different from that of DMARD treatment and independent of clinical responses.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hanova, P" uniqKey="Hanova P">P Hanova</name></author><author><name sortKey="Pavelka, K" uniqKey="Pavelka K">K Pavelka</name></author><author><name sortKey="Dostal, C" uniqKey="Dostal C">C Dostal</name></author><author><name sortKey="Holcatova, I" uniqKey="Holcatova I">I Holcatova</name></author><author><name sortKey="Pikhart, H" uniqKey="Pikhart H">H Pikhart</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Silman, Aj" uniqKey="Silman A">AJ Silman</name></author><author><name sortKey="Pearson, Je" uniqKey="Pearson J">JE Pearson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Symmons, D" uniqKey="Symmons D">D Symmons</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id><journal-id journal-id-type="publisher-id">ard</journal-id><journal-title-group><journal-title>Annals of the Rheumatic Diseases</journal-title></journal-title-group><issn pub-type="ppub">0003-4967</issn><issn pub-type="epub">1468-2060</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18829616</article-id><article-id pub-id-type="pmc">2674552</article-id><article-id pub-id-type="publisher-id">ar92734</article-id><article-id pub-id-type="doi">10.1136/ard.2008.092734</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical and Epidemiological Research</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject></subj-group><series-title>Extended report</series-title></article-categories><title-group><article-title>Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group</article-title><alt-title alt-title-type="running-head">Extended report</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Halpern</surname><given-names>M T</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cifaldi</surname><given-names>M A</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kvien</surname><given-names>T K</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Health Policy and Management, Emory University, Atlanta, Georgia, USA</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, Illinois, USA</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, and Faculty of Medicine, University of Oslo, Oslo, Norway</addr-line></aff><author-notes><corresp>Correspondence to: Dr M Halpern, Emory University, Department of Health Policy and Management, 1599 Clifton Road, Atlanta, Georgia 30329, USA; <email>mthalpe@emory.edu</email></corresp></author-notes><pub-date pub-type="collection"><month>6</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>1</day><month>10</month><year>2008</year></pub-date><volume>68</volume><issue>6</issue><fpage>930</fpage><lpage>937</lpage><history><date date-type="accepted"><day>17</day><month>9</month><year>2008</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2009</copyright-year><license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="ard-68-06-0930.pdf"></self-uri><abstract><sec><title>Background and objectives:</title><p>Rheumatoid arthritis (RA) causes considerable disability and often results in loss of work capacity and productivity. This study evaluated the impact of adalimumab, a tumour necrosis factor antagonist with demonstrated efficacy in RA, on long-term employment.</p></sec><sec><title>Methods:</title><p>Data from an open-label extension study (DE033) of 486 RA patients receiving adalimumab monotherapy who previously did not respond to at least one disease-modifying antirheumatic drug (DMARD) and had baseline work status information were compared with data from 747 RA patients receiving DMARD treatment in a Norway-based longitudinal registry. Primary outcomes included the time patients continued working at least part time and the likelihood of stopping work. Secondary outcomes included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) responses and disease remission. Outcomes were compared 6, 12 and 24 months after enrolment.</p></sec><sec><title>Results:</title><p>During a 24-month period, the 158 patients who received adalimumab and were working at baseline worked 7.32 months longer (95% CI 4.8 to 9.1) than did the 180 patients treated with DMARDs, controlling for differences in baseline characteristics. Regardless of baseline work status, patients receiving adalimumab worked 2.0 months longer (95% CI 1.3 to 2.6) and were significantly less likely to stop working than those receiving DMARDs (HR 0.36 (95% CI −0.30 to 0.42) for all patients and 0.36 (95% CI 0.15 to 0.85) for patients working at baseline, respectively). The patients who received adalimumab were also considerably more likely to achieve ACR responses and disease remission than DMARD-treated patients. Patients who achieved EULAR good response and remission were less likely to stop working, but this relationship was only seen in patients receiving DMARDs.</p></sec><sec><title>Conclusions:</title><p>Patients with RA who received adalimumab experienced considerably longer periods of work and continuous employment, and greater rates of clinical responses, than patients receiving DMARDs. The mechanism by which adalimumab decreases likelihood of stopping work seems to be different from that of DMARD treatment and independent of clinical responses.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>special-feature</meta-name><meta-value>unlocked</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Norvège</li><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li><li>Illinois</li></region></list><tree><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Halpern, M T" sort="Halpern, M T" uniqKey="Halpern M" first="M T" last="Halpern">M T Halpern</name></region><name sortKey="Cifaldi, M A" sort="Cifaldi, M A" uniqKey="Cifaldi M" first="M A" last="Cifaldi">M A Cifaldi</name></country><country name="Norvège"><noRegion><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T K" last="Kvien">T K Kvien</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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