Background/Purpose: The impact of disease activity on household productivity has not been studied in detail. This analysis evaluated if baseline (BL) tender/swollen joint counts (TJC/SJC) are associated with and predict household productivity in patients (pts) with active rheumatoid arthritis (RA) receiving certolizumab pegol (CZP) plus methotrexate (MTX).
Method: Pooled data at 1 year for CZP 200 and 400 mg completers from RAPID 1 (NCT00152386) and RAPID 2 and its open-label extension (NCT00160602/NCT00160641) were used. Household productivity (missed days of household work, days with reduced household productivity, days with outside help hired, missed days of family/social/leisure activities) was assessed using the Work Productivity Survey (WPS-RA).1 Frequency distribution of WPS-RA scores over time was summarized by TJC/SJC BL 25% and 75% quartiles. Hand, large upper extremity (shoulder, elbow, hand), large lower extremity (hip [tenderness], knee, ankle), or total JC were assessed. Analyses were conducted on observed data (no imputation of missing data).
Result: At BL higher disease activity was associated with higher impairment in household duties and social activities (Table). Pts receiving CZP had rapid, sustained improvements in household productivity over time in all TJC/SJC quartiles. Over 1 year, fewer days of household work were missed per month in pts with lower (≤25% quartile) vs higher (>75% quartile) TJC BL scores in large lower extremity joints: by Week 4 (Wk) 69.2% vs 57.0% of pts missed ≤4 days of household work per month, increasing to 82.4% vs 72.7% by Wk 12 and by Wk 48, to 89.0% vs 82.6% (Figure). Although improvements in household productivity were reported by pts with higher BL TJC scores in the lower extremities, these were consistently smaller vs pts with lower BL TJC scores. Similarly pts with lower TJC BL scores in large lower extremity joints had greater reductions in days with reduced productivity and in days with outside help hired vs pts with higher BL scores. Fewer days of family/social/leisure activities were missed per month in pts with lower vs higher hand/total TJC BL scores. Pts with higher vs lower SJC BL scores had similar improvements in household productivity over time; there were no differences between the 2 groups at Wk 48.
Conclusion: At BL higher TJC/SJC scores were associated with increased impairment in household productivity. Improvements in household productivity were seen with CZP treatment in both pts with lower vs higher BL TJC scores, with greater improvements in pts with lowest BL TJC scores.
- Osterhaus J, et al. Arthritis Res Ther 2009;11:R73.
Disclosure: A. Kavanaugh, UCB Inc, 5 ; O. Purcaru, UCB Inc, 3 ; J. Smolen, UCB Inc, 2, UCB Inc, 5 ; P. Emery, UCB Inc, 2, UCB Inc, 5 ; V. Strand, UCB Inc, 5 ; E. Keystone, UCB Inc, 2, UCB Inc, 5, UCB Inc, 8 ; R. F. van Vollenhoven, UCB Inc, 2, UCB Inc, 5 .