Background/Purpose:

Compared to the
general population, patients (pts) with psoriatic arthritis (PsA) suffer
greater amounts of disability and substantially lower employment rates.¹
Few studies have evaluated the association between improvements in workplace
and household productivity and symptom relief with available therapies in PsA
pts. Here we evaluate the
association between improvements in clinical and pt-reported outcomes (PROs)
and improvements in productivity in the workplace and at home in PsA pts
treated with certolizumab pegol (CZP).

Methods:

Associations between
clinical outcomes or PROs and work and household productivity outcomes were compared
using Week (Wk) 24 data from the double-blind and placebo-controlled period of
RAPID-PsA (NCT01087788).² Clinical outcomes included achievement of ACR20/50,
PsARC and PASI75 responses, and DAS28 remission (DAS28<2.6). PROs included achievement
of MCID for HAQ-DI (≥0.3 decrease from baseline [BL]), pain (≥10 mm
decrease from BL) and fatigue (≥1 decrease from BL). Responders and
non-responders at Wk24 for clinical outcomes and PROs were compared in terms of
change from BL (CFB) in workplace and household productivity, as assessed using
the validated arthritis-specific Work Productivity Survey (WPS).³
Analyses were carried out for pts originally randomized to CZP. Groups were
compared using a non-parametric bootstrap-t method. Missing data were imputed using
last observation carried forward for WPS outcomes and non-responder imputation
for clinical outcomes and PROs.

Results:

273 CZP pts entering
RAPID-PsA were included in Wk24 analyses. 61.9% of pts were employed at Wk24. Overall,
pts achieving a clinical or PRO response at Wk24 also reported greater
improvements in workplace and household productivity than non-responders (Table).
Improvements in both joint and skin symptoms, and clinically meaningful
reductions in disability, pain and fatigue were associated with improved
workplace absenteeism and presenteeism. Responders also reported greater
improvements in their participation in family, social and leisure activities (data
not shown). Results should be interpreted with caution due to differences in
the number of pts between responder and non-responder groups, and because the
analyses were not adjusted for differences in BL productivity between these groups.

Conclusion:

Clinical responses in
joint and skin outcomes as well as clinically meaningful improvements in PROs
are associated with improved workplace and household productivity in PsA pts
treated with CZP.

References:

1.   
Mau W.
J Rheumatol 2005;32:721–8

2.   
Mease
P. J. Ann Rheum Dis 2014;73:48–55

3.   
Osterhaus
J. Arthritis Res Ther 2014;16:R140