Rheumatoid arthritis (RA) patients may experience several employment-related challenges as a result of their disease. In addition to time lost due to sick leave and disability, patients may also suffer due to lost productivity on a day-to-day basis. A new study evaluated work-related outcomes among RA patients treated with adalimumab for two years.
“Recent studies on the effect of therapeutic intervention on work productivity have examined work-related outcomes over a period of 6 to 12 months or have focused on patients with specific characteristics, such as early RA,” the study authors explained. “There is thus a need to further characterize the effects of longer-term treatment, particularly in patients with extended disease durations.”
The researchers assessed an observational cohort of German RA patients who were employed either part- or full-time, initiated adalimumab treatment, and continued treatment for two years. The main outcomes were six-month self-reported sick leave days, absenteeism, presenteeism, and total work productivity impairment per the Work Productivity and Activity Impairment (WPAI) questionnaire and disease activity assessments.
Final analysis included 783 patients, most of whom (72.3%) were female. The mean age was 47.9 years, and the mean disease duration was 7.8 years. Before adalimumab treatment, 42.9% of patients had a six-month history of higher than normal sick leave days—defined as more than five. Among the patients with higher than normal sick leave days at baseline, close to two-thirds (61%) returned to normal sick leave values—defined as five days or fewer per six months—over the two years of adalimumab treatment. At the two-year mark, mean sick leave days per six months in the entire cohort decreased from 14.8 days at baseline to 7.4 days. WPAI assessments and disease activity measures demonstrated improvements, but presenteeism, pain, and fatigue levels remained high at two years.
The study was published in the September issue of Clinical Rheumatology.
“It is possible that pain and fatigue contribute to reduced productivity at work, and that targeted management of these symptoms, including exploration of possibly contributory comorbidities, such as osteoarthritis, cardiovascular disease, or depression, may help improve patient global health and work-related outcomes,” the study authors suggested in their conclusion.