Background/Purpose: Rheumatoid arthritis (RA) is associated with work disability
and lower employment rates (evidence shows 20–30% of
pts are work disabled in the first 3 yrs and up to 40–50% in
the first 10 yrs of RA). Improvements in workplace/household productivity with
certolizumab pegol (CZP)+MTX have been reported in established RA.¹
Here we estimate the RA burden on work disability in DMARD-naïve early RA vs
established RA and assess the CZP+MTX effect on workplace/household
productivity in DMARD-naïve early RA pts over 52 wks.

Methods:
C-EARLY (NCT01519791) is a phase 3 study assessing efficacy and safety of CZP
in DMARD-naïve pts with severe, active and progressive RA (≤1 yr since
diagnosis) and poor prognostic factors.² RAPID1 (NCT00152386) and
RAPID2 (NCT00160602) reported efficacy and safety of CZP in pts with active RA
of ≥6 months’ duration on MTX for ≥6 months prior to baseline (BL).¹
The burden of early/established RA on workplace and household productivity was
assessed at study BL in C-EARLY (full analysis set [FAS]) and pooled RAPID1/2
studies (intent-to-treat [ITT] population), using the validated arthritis
specific Work Productivity Survey (WPS).³ WPS responses (LOCF
imputation) in C-EARLY were compared between groups using a non-parametric
bootstrap-t method.

Results:
At BL, mean age, disease activity and functioning were similar between early
and established RA pts (early/established RA: age 50.6/52 yrs; DAS28(ESR)
6.7/6.9; HAQ-DI 1.6/1.6) with differences in mean disease duration since
diagnosis (early/established RA: 2.9 months/6.1 yrs) and mean prior synthetic
DMARD use (early/established RA: 0/1.3). More early RA pts were employed vs
established RA; (52.2% vs 40.9%); more established RA pts were RA work disabled
vs early RA (22.3% vs 10.5%) (Table A). High RA burden was reported at BL in
both early and established RA pts with >2 wks of paid work (mean 13.3 vs
11.4 days), >2 wks of household duties (mean 18.9 vs 18.1 days), and mean
5.2 vs 5.6 days of social activities affected over previous month, respectively
(Table A). At Wk52 in DMARD-naïve pts, greater improvements were reported in
CZP+MTX arm vs PBO+MTX in household productivity, and in absenteeism and
presenteeism (employed pts only) (Table B).

Conclusion:
DMARD-naïve pts with early severe RA and poor prognostic factors have a similar
high burden on workplace and household productivity to that reported in
established RA, which could lead to large financial burden for pts and society.
CZP+MTX showed greater improvements at 1 yr in workplace and household
productivity in DMARD-naïve pts with severe, active, progressive RA (≤1 yr
since diagnosis), which could reduce the economic burden of this disease.

References:

1. Kavanaugh A.
Arthritis Rheum 2009;61(11):1592–1600

2. Emery P. Ann Rheum
Dis 2015;74(S2):712

3. Osterhaus J.
Arthritis Res Ther 2009;11:R7