Session Type: Poster Session (Monday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Patients (pts) with non-radiographic axial spondyloarthritis (nr-axSpA) report substantial impairment of productivity and daily activities due to the burden of their disease, similar to pts with ankylosing spondylitis.1,2 Certolizumab pegol (CZP) treatment has been shown to significantly improve work and household productivity and social participation compared to placebo (PBO) in active nr-axSpA pts up to 24 weeks (wks).1 Improvements were maintained over 4 years of CZP treatment in RAPID-axSpA.3 The C-axSpAnd study demonstrated the impact of CZP in combination with non-biologic background medication (NBBM) on signs and symptoms of nr-axSpA compared to PBO + NBBM.4 Here, we report work and household productivity and social participation from C-axSpAnd.
Methods: C-axSpAnd (NCT02552212) is a 3-year, phase 3, multicenter study including a 52 wk double-blind, PBO-controlled period (completed). Pts had active nr-axSpA, objective signs of inflammation (elevated CRP and/or positive MRI of the sacroiliac joint), and previous inadequate response to ≥2 NSAIDs and were randomized 1:1 to CZP (400 mg at Wks 0, 2, and 4, then 200 mg every 2 wks) + NBBM or PBO + NBBM. The validated arthritis-specific Work Productivity Survey (WPS) assessed the impact of nr-axSpA on work and household productivity and social participation.5 Missing data were imputed using last observation carried forward (LOCF) post hoc in the Full Analysis Set (FAS, all randomized pts who received ≥1 dose of study medication).
Results: 317 pts were randomized (CZP + NBBM: 159; PBO + NBBM: 158). Mean age at baseline (BL) was 37.3 years and 51.4% of pts were female. At BL, the majority of pts (CZP + NBBM: 124 [77.8%]; PBO + NBBM: 123 [78.0%] pts) were employed and reported a mean 3.7 (CZP + NBBM) and 3.5 (PBO + NBBM) work days missed per month due to their disease (Table). By Wk 12, work absenteeism substantially improved in the CZP + NBBM group compared with the PBO + NBBM group (0.9 vs 2.1 days missed per month, LOCF), with further improvements at Wk 52 (0.3 vs 2.0 days missed per month, LOCF). Between Wk 12 and Wk 52, a majority of PBO pts (104 [65.8%]) switched to open-label CZP, impacting imputed outcomes at Wk 52. Despite this, similar patterns of improvement following CZP + NBBM treatment were seen for absenteeism, work days with impaired productivity, household days with missed/reduced productivity and social participation between imputed and observed case data (Table). Improvements were similar between male and female pts (data not shown).
Conclusion: CZP treatment resulted in improvements in work and household productivity and social participation for nr-axSpA pts as early as Wk 12 compared to background medication only, with benefits maintained to Wk 52.
1. van der Heijde D. RMD Open 2018;4:e000659; 2. Keat A. Rheumatol Int. 2017;37(3):327-36; 3. van der Heijde D. ARD 2016;75:809; 4. Deodhar A. Arthritis Rheum 2019;doi:10.1002/art.40866; 5. Osterhaus JT. Arthritis Res Ther 2014;16:R164
To cite this abstract in AMA style:Deodhar A, Gensler L, Kay J, Maksymowych W, Haroon N, Landewé R, Rudwaleit M, Hall S, Bauer L, Hoepken B, de Peyrecave N, Kumke T, van der Heijde D. Certolizumab Pegol Improves Work and Household Productivity and Social Participation over 1 Year of Treatment in Patients with Non-Radiographic Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/certolizumab-pegol-improves-work-and-household-productivity-and-social-participation-over-1-year-of-treatment-in-patients-with-non-radiographic-axial-spondyloarthritis/. Accessed November 25, 2020.
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