| Citation: |
Bejarano, V., Quinn, M., Conaghan, P. G., Reece, R., Keenan, A.-M., Walker, D., Gough, A., Green, M., McGonagle, D., Adebajo, A., Jarrett, S., Doherty, S., Hordon, L., Melsom, R., Unnebrink, K., Kupper, H., & Emery, P. (2008). Effect of the early use of the anti–tumor necrosis factor adalimumab on the prevention of job loss in patients with early rheumatoid arthritis.
Arthritis Care & Research, 59
(10),
1467-1474.
|
| Title: |
Effect of the early use of the anti–tumor necrosis factor adalimumab on the prevention of job loss in patients with early rheumatoid arthritis |
| Authors: |
Bejarano, V., Quinn, M., Conaghan, P. G., Reece, R., Keenan, A.-M., Walker, D., Gough, A., Green, M., McGonagle, D., Adebajo, A., Jarrett, S., Doherty, S., Hordon, L., Melsom, R., Unnebrink, K., Kupper, H., & Emery, P. |
| Year: |
2008 |
|
Journal/Publication:
|
Arthritis Care & Research |
| Publisher: |
American College of Rheumatology |
| DOI: |
https://doi.org/10.1002/art.24106
|
| Full text: |
http://proxy.library.vcu.edu/login?url=http://onlinelibrary.wiley.c...
|
| Peer-reviewed? |
Yes
|
| NIDILRR-funded? |
No
|
|
Research design:
|
Randomized controlled trial
|
| Background: |
The impact of rheumatoid arthritis (RA) on work disability and job loss represents a significant economic burden. Recent developments in therapies targeted against tumor necrosis factor (TNF)have changed the approach to RA treatment by rapidly controlling the disease. |
|
Purpose:
|
To compare work disability and job loss in early rheumatoid arthritis (RA) patients receiving adalimumab plus methotrexate (adalimumab + MTX) versus MTX alone. |
|
Setting:
|
The setting included a variety of medical centers providing treatment for rheumatoid arthritis. |
|
Study sample: |
In this multicenter, randomized, controlled trial, patients with RA for <2 years who had never taken MTX and who self-reported work impairment were randomized to adalimumab + MTX or placebo + MTX for 56 weeks. |
|
Intervention:
|
The intervention was adalimumab + MTX. |
|
Control or comparison condition:
|
The comparison was treatment using MTX alone. |
|
Data collection and analysis:
|
Primary outcome was job loss of any cause and/or imminent job loss at or after week 16. Secondary outcomes included disease activity, function (Health Assessment Questionnaire [HAQ] score), and RA quality of life (RAQoL) questionnaire score. Work was evaluated with work diaries and the RA Work Instability Scale. |
|
Findings:
|
Although job loss during the 56-week study was significantly lower with adalimumab + MTX (14 of 75 patients) compared with MTX alone (29 of 73 patients; P = 0.005), the primary end point was not met (12 of 75 versus 20 of 73 patients; P = 0.092), likely owing to early drop out in the MTX group. There were significant improvements in American College of Rheumatology 20% response criteria, 28-joint Disease Activity Score, HAQ, RAQoL, and working time lost in the adalimumab + MTX group. Twenty-four serious adverse events were reported in 17 participants, with no differences between groups. |
|
Conclusions:
|
Adalimumab + MTX reduced job loss and improved productivity in early RA when compared with MTX alone, which supports the early use of anti–tumor necrosis factor therapy and suggests its cost efficacy. |
