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Abstract Number: 1520

Reduction Of Disease Burden On Workplace and Household Productivity In Axial Spondyloarthritis, Including Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis, Over 48 Weeks Of Treatment With Certolizumab Pegol

Désirée M. van der Heijde1, Jürgen Braun2, Martin Rudwaleit3, Oana Purcaru4 and Arthur Kavanaugh5, 1Dept of Rheumatology, Leiden University Medical Center, Leiden, Netherlands, 2Rheumazentrum Ruhrgebiet, Herne, Germany, 3Endokrinologikum, Berlin, Germany, 4UCB Pharma, Brussels, Belgium, 5Division of Rheumatology Allergy and Immunology, University of California San Diego, San Diego, CA

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: anti-TNF therapy, certolizumab pegol, quality of life, spondylarthritis and work

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Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment: II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Axial spondyloarthritis (axSpA) includes both ankylosing spondylitis (AS, meeting modified New York criteria) and axSpA with no sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA). AS significantly affects work productivity1 but data is limited for the impact of nr-axSpA on productivity. Previous results show improvements in workplace and household productivity with certolizumab pegol (CZP) vs placebo (PBO) up to Week (Wk) 24 in the RAPID-axSpA study.2 This report estimates the economic burden of axSpA, AS and nr-axSpA, and examines long-term effects of CZP on productivity outcomes up to Wk48.

Methods: The ongoing RAPID-axSpA trial (NCT01087762) is double-blind and PBO-controlled to Wk24 and dose-blind to Wk48.3 Patients (pts) had active axSpA according to ASAS criteria,4 including both AS and nr-axSpA pts. Pts originally randomized to CZP (200mg Q2W or 400mg Q4W, following 400mg loading dose at Wks 0, 2, 4) continued on their assigned dose in dose-blind phase; PBO pts entering dose-blind phase were re-randomized to CZP loading dose followed by CZP 200mg Q2W or CZP 400mg Q4W. The arthritis-specific Work Productivity Survey (WPS),5 administered Q4W from baseline (BL), assessed the impact of axSpA on workplace and household productivity in the full analysis set (FAS). Disease burden was evaluated at study BL. WPS responses (LOCF imputation) in both CZP groups are summarized descriptively over 48 wks.

Results: BL disease activity was similar for AS and nr-axSpA pts but symptom duration varied (median 9.1 vs 5.5 yrs, respectively). At BL, 69.2% of axSpA pts, 67.4% AS and 71.4% nr-axSpA were employed outside the home. More AS vs nr-axSpA pts were unable to work due to spondyloarthritis (15.7% vs 8.2%). High burden of axSpA on workplace and household productivity was reported at BL, with higher burden in nr-axSpA vs AS (Table). At BL, axSpA pts reported >1 wk of paid work (mean 7.2 days), ~2 wks of household duties (mean 13.3 days), and mean 4.4 days of social activities affected over previous month. Employed pts in both CZP groups reported reductions in workplace absenteeism and presenteeism to Wk24, with further improvements to Wk48 (Table). CZP groups reported continued improvements in household productivity up to Wk48 (Table). Similar improvements were observed in AS and nr-axSpA (Table).

Conclusion: At BL, similarly high burden of disease on workplace and household productivity was seen in AS and nr-axSpA pts that could lead to a large financial burden for pts and society. This analysis indicates that CZP continued to improve workplace and household productivity in axSpA pts over 48 wks. Similar CZP improvements over time were observed in AS and nr-axSpA.

References: 1. Boonen A. Ann Rheum Dis 2010;69(6):1123-1128; 2. van der Heijde D. Ann Rheum Dis 2013;72(3):87; 3. Landewé R. Arthritis Rheum 2012;64(10):336-337; 4. Rudwaleit M. Ann Rheum Dis 2009;68(6):770-776; 5. Osterhaus J. Arth Res Ther 2009;11(3):R73


Disclosure:

D. M. van der Heijde,

AbbVie, Amgen, AstraZeneca, Augurex, Bristol-Myers Squibb, Celgene, Centocor, Chugai, Covagen, Daiichi, Eli-Lilly, GSK, Janssen Biologics, Merck, Novartis, Novo-Nordisk, Otsuka, Pfizer, Roche, Sanofi-Aventis, Schering-Plough, UCB Pharma, Vertex,

5,

Imaging Rheumatology bv,

9;

J. Braun,

Abbott, Bristol-Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma,

2,

Abbott, Bristol-Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma,

5;

M. Rudwaleit,

Abbott, Bristol-Myers Squibb, MSD, Pfizer, Roche, UCB Pharma,

5;

O. Purcaru,

UCB Pharma,

3;

A. Kavanaugh,

Abbott, Amgen, Bristol-Myers Squibb, Pfizer, Roche, Janssen, UCB Pharma,

2.

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