Early Rheumatoid Arthritis Work Productivity Improved with Combination Therapy

Improvements in paid and unpaid work activity were demonstrated using etanercept (ETN; brand name Enbrel) and methotrexate (MTX), according to findings published in Rheumatic & Musculoskeletal Diseases.

Researchers from hospitals in Vancouver, British Columbia, Canada observed 196 early RA patients who had the disease for at least 52 weeks in order to measure and value the impact of combination ETN and MTX therapy on work productivity in this patient population.

The patients were biological-naïve and had a Disease Activity Score based on a 28 joint count of less than 3.2. The patients completed The Valuation of Lost Productivity (VOLP) questionnaire every 13 weeks, a test which is designed to measure paid and unpaid work productivity impacts. One year productivity impacts were compared between the responders at week 13 and non responders using analysis models.

There were 196 patients employed at baseline and had at least one or more year of follow up with the VOLP questionnaire. At week 52, patients gained 33.4 hours per 3 months in paid work and an additional 4.2 unpaid hours per week compared to the baseline measurements.

The monetary values for this time period were $1,438 per 3 months. Across the entire 1 year period, responders earned 231 paid hours and unpaid work loss totaled 122 hours. Compared to the non responders, responders earned just shy of $4,000.

“Combination therapy with ETN50/ MTX was associated with a significant productivity gain for patients with early RA who were still observed at week 52,” the authors wrote. “Over the 1 year treatment period, responders at week 13 suffered significantly less productivity loss than non responders suggesting this gain was related to treatment response.”

The researchers noted that this was the first trial to measure and value the impact of biological treatments on the labor input components that affect overall productivity in the afflicted patients.

“The ability to work is one of the most valued areas for patients with RA,” the authors continued. “Developing effective treatments and strategies to improve patient work productivity in patients with early RA is therefore an important priority.”