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Impact of biological therapy on work outcomes in patients with axial spondyloarthritis: results from the British Society for Rheumatology Biologics Register (BSRBR-AS) and meta-analysis.

Shim, Joanna; Jones, Gareth T.; Pathan, Ejaz M.I.; Macfarlane, Gary J.

Authors

Gareth T. Jones

Ejaz M.I. Pathan

Gary J. Macfarlane



Abstract

Objectives: To quantify, among patients with axial spondyloarthritis (axSpA), the benefit on work outcomes associated with commencing biologic therapy. Methods: The British Society for Rheumatology Biologics Register in Axial Spondyloarthritis (BSRBRAS) recruited patients meeting Assessment of SpondyloArthritis International Society criteria for axSpA naïve to biological therapy across 83 centres in Great Britain. Work outcomes (measured using the Work Productivity and Activity Impairment Index) were compared between those starting biological therapy at the time of recruitment and those not. Differences between treatment groups were adjusted using propensity score matching. Results from BSRBR-AS were combined with other studies in a meta-analysis to calculate pooled estimates. Results: Of the 577 participants in this analysis who were in employment, 27.9% were starting biological therapy at the time of recruitment. After propensity score adjustment, patients undergoing biological therapy, at 12-month follow-up, experienced significantly greater improvements (relative to non-biological therapy) in presenteeism (−9.4%, 95% CI −15.3% to –3.5%), overall work impairment (−13.9%, 95% CI −21.1% to –6.7%) and overall activity impairment (−19.2%, 95% CI −26.3% to –12.2%). There was no difference in absenteeism (−1.5%, 95% CI −8.0 to 4.9). Despite these improvements, impact on work was still greater in the biological treated cohort at follow-up. In the meta-analysis including 1109 subjects across observational studies and trials, treatment with biological therapy was associated with significantly greater improvements in presenteeism, work impairment and activity impairment, but there was no difference in absenteeism. Conclusions: There is consistent evidence that treatment with biological therapy significantly improves work productivity and activity impairment in people with axSpA. However, there remain substantial unmet needs in relation to work.

Citation

SHIM, J., JONES, G.T., PATHAN, E.M.I. and MACFARLANE, G. 2018. Impact of biological therapy on work outcomes in patients with axial spondyloarthritis: results from the British Society for Rheumatology Biologics Register (BSRBR-AS) and meta-analysis. Annals of the rheumatic diseases [online], 77(11), pages 1578-1584. Available from: http://dx.doi.org/10.1136/annrheumdis-2018-213590

Journal Article Type Article
Acceptance Date Jul 18, 2018
Online Publication Date Aug 3, 2018
Publication Date Nov 30, 2018
Deposit Date Nov 30, 2021
Publicly Available Date Mar 29, 2024
Journal Annals of the Rheumatic Diseases
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 77
Issue 11
Pages 1578-1584
DOI https://doi.org/10.1136/annrheumdis-2018-213590
Keywords General Biochemistry, Genetics and Molecular Biology; Immunology; Immunology and Allergy; Rheumatology
Public URL https://rgu-repository.worktribe.com/output/1447239

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