Work productivity in patients with axial spondyloarthritis initiating biological or targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review and meta-analysis

Martin Rudwaleit*, Michael F. Mørup, Brittany Humphries, Noor E. Zannat, Damon Willems, Vanessa Taieb, Annelies Boonen

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

BACKGROUND: Axial spondyloarthritis (axSpA) can limit work participation. Our objective was to characterise productivity in patients with axSpA, including changes after 12-16 weeks of treatment with biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). METHODS: A systematic literature review identified studies published from 1 January 2010 to 21 October 2021 reporting work productivity using the Work Productivity and Activity Impairment (WPAI) questionnaire in patients with axSpA initiating b/tsDMARDs. Baseline and Week 12-16 overall work productivity, absenteeism, presenteeism and activity impairment scores were used in a random-effects meta-analysis to calculate absolute mean change from baseline for each WPAI-domain. RESULTS: Eleven studies in patients with axSpA who received either placebo (n=727) or treatment with adalimumab, bimekizumab, etanercept, ixekizumab, secukinumab or tofacitinib (n=994) were included. In working patients initiating a b/tsDMARD, mean baseline overall work productivity impairment, absenteeism and presenteeism scores were 52.1% (N=7 studies), 11.0% and 48.8% (N=6 studies), respectively. At Week 12-16, the pooled mean change from baseline in overall work impairment for b/tsDMARDs or placebo was -21.6% and -12.3%. When results were extrapolated to 1?year, the potential annual reductions in cost of paid and unpaid productivity loss per patient ranged from €11?962.88 to €14?293.54. CONCLUSIONS: Over 50% of employed patients with active axSpA experienced work impairment, primarily due to presenteeism. Overall work productivity improved at Weeks 12-16 to a greater extent for patients who received b/tsDMARDs than placebo. Work productivity loss was associated with a substantial cost burden, which was reduced with improvements in impairment.
Original languageEnglish
Article numbere003468
Number of pages15
JournalRMD Open
Volume9
Issue number4
DOIs
Publication statusPublished - 30 Nov 2023

Keywords

  • Antirheumatic Agents
  • Inflammation
  • Outcome Assessment, Health Care
  • Patient Reported Outcome Measures
  • Spondylitis, Ankylosing

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