ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1453

Impact of Biological and Targeted Synthetic Dmards on Work in Patients with Chronic Inflammatory Arthritides : A Meta Analysis of Randomized Controlled Trials and Controlled Cohorts

Charlotte Traverson1, Amandine Tubery1, Charlotte Hua2, Françoise Barchechath-Flaisler1, Cédric Lukas3, Bernard Combe2, Jacques Morel2 and Cécile Gaujoux-Viala4, 1Rheumatology, Nîmes University Hospital, Nîmes, France, 2Rheumatology, CHU Lapeyronie and Montpellier University, Montpellier, France, 3Rheumatology, CHU Lapeyronie and EA2415, Montpellier University, University of Montpellier, France, 4Rheumatology, Nîmes University Hospital and EA2415 Montpellier University, Nîmes, France

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: , , ,

Session Information

Date: Monday, November 6, 2017

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy Poster II: Prognostic Factors, Imaging and Miscellaneous Reports

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The addition of biological (b) and new targeted synthetic (ts) DMARDs agents in chronic inflammatory arthritides (CIAs) therapeutic strategies has improved the possibility of controlling disease activity and slowing the progression of joint damage. However their impact on work participation is unclear.

Objective: to assess the effect of biological and tsDMARDs versus conventional treatments in patients with CIAs on work outcomes : employment, presenteeism and absenteeism.

Methods: A systematic review of the literature using Pubmed-Medline and the Cochrane library was performed until January 2017. All randomized controlled trials (RCT) and controlled cohorts (CC) comparing work outcomes in patients with rheumatic diseases such as rheumatic arthritis (RA), ankylosing spondylarthris (AS) and psoriatic arthritis (PsA) treated with biological or tsDMARDs versus conventional therapies were selected. Statistical analysis determined in each study effect size (ES) or odds-ratios (OR) as appropriate to assess the magnitude of treatment effect. Pooled ES and OR were computed by meta-analysis. A random effect model was used in case of heterogeneity.

Results:

Thirty three RCTs and 8 CCs were analyzed ie 12306 patients with conventional treatment and 21328 patients with bDMARD or tsDMARD (6610 Infliximab, 5613 Etanercept, 3820 Adalimumab, 672 Golimumab, 2935 Certolizumab, 691 Abatacept, 444 Sirukumab, 351 Baricitinib); 26 studies included 29592 patients with RA, 10 studies included 2226 patients with AS and 5 studies included 1816 patients with PsA.

This meta-analysis showed in patients treated by bDMARD vs conventional treatment:

– a significant decrease of accumulated missed workdays at week 24: ES -0.34 IC95%[-0.6; -0.08] and at week 52: ES -0.04 IC95% [–0.29; 0.2],

– a significant decrease of patients loosing hours due to CIAs: RR 0.63 IC95%[0.48; 0.83],

– a significant improvement in VAS productivity: ES -1.81 IC95%[-2.61; -1.01] and in activity impairment (WPAI): ES -10,57 IC95% [-13,99; -7,14].

– For the employment loss, the positive effect of bDMARDs was nearly significant: OR 0.60 IC95% [0.33; 1.09].

Conclusion: Despite the heterogeneity of the data, this meta-analysis showed the beneficial effect of bDMARDs on both absenteeism and presenteeism in CIAs. Thus the high cost of biologic agents could be partly balanced with savings in indirect costs.

Disclosure: C. Traverson, None; A. Tubery, None; C. Hua, Abbvie,BMS, Pfizer, 5; F. Barchechath-Flaisler, Roche Pharmaceuticals, 5; C. Lukas, Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Sanofi, Schering, Roche- Chugai, UCB, 5; B. Combe, Pfizer, UCB, 2,BMS, Janssen, Lilly, MSD,Pfizer, Roche-Chugai, UCB, 8,Abbvie, BMS,Janssen, Lilly, MSD,Novartis, Pfizer, Roche-Chugai, UCB, 5; J. Morel, Abbvie, BMS, Celgene, Janssen, Medac, MSD, Novartis, Pfizer, Sanofi, Schering, Roche- Chugai, UCB, 5; C. Gaujoux-Viala, Pfizer Inc, 2,Abbvie, BMS, Celgene, Janssen, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi, Roche- Chugai, UCB, 5.

To cite this abstract in AMA style:

Traverson C, Tubery A, Hua C, Barchechath-Flaisler F, Lukas C, Combe B, Morel J, Gaujoux-Viala C. Impact of Biological and Targeted Synthetic Dmards on Work in Patients with Chronic Inflammatory Arthritides : A Meta Analysis of Randomized Controlled Trials and Controlled Cohorts [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/impact-of-biological-and-targeted-synthetic-dmards-on-work-in-patients-with-chronic-inflammatory-arthritides-a-meta-analysis-of-randomized-controlled-trials-and-controlled-cohorts/. Accessed .

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