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Meta-Analysis
. 2018 Nov;77(11):1578-1584.
doi: 10.1136/annrheumdis-2018-213590. Epub 2018 Aug 3.

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

Joanna Shim  1   2   3 , Gareth T Jones  1   2   3 , Ejaz M I Pathan  4 , Gary J Macfarlane  1   2   3
Affiliations
Meta-Analysis

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

Joanna Shim et al. Ann Rheum Dis. 2018 Nov.

Erratum in

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.

Keywords: axial spondyloarthritis; biologic therapy; meta-analysis; work.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Crude changes in work outcomes after 1 year: BSRBR-AS study. BSRBR-AS, British Society of Rheumatology Biologics register in Axial Spondyloarthritis.
Figure 2
Figure 2
PRISMA flow chart of study selection and inclusion (modified from Moher et al 23). BSRBR-AS, British Society for Rheumatology Biologics Register in Axial Spondyloarthritis; OM, outcome measure; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PsA, psoriatic arthritis; RA, rheumatoid arthritis.
Figure 3
Figure 3
Forest plot comparing changes in WPAI outcomes between patients in the biological and non-biological treatment groups. BSRBR-AS, British Society of Rheumatology Biologics register in Axial Spondyloarthritis; WPAI, Work Productivity and Activity Impairment.
See this image and copyright information in PMC

References

    1. Bryngelson A. Long-term sickness absence and social exclusion. Scand J Public Health 2009;37:839–45. 10.1177/1403494809346871 - DOI - PubMed
    1. Waddell G, Burton AK. Great Britain: Department for Work. Is work good for your health and well-being? London: Stationery Office, 2006.
    1. Boonen A, Brinkhuizen T, Landewé R, et al. . Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost. Ann Rheum Dis 2010;69:1123–8. 10.1136/ard.2009.116764 - DOI - PubMed
    1. Cakar E, Taskaynatan MA, Dincer U, et al. . Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 2009;28:1309–14. 10.1007/s10067-009-1249-1 - DOI - PubMed
    1. Ramos-Remus C, Hernandez-Rios G, Duran-Barragan S, et al. . Fifteen-year trends of long-term disability and sick leaves in ankylosing spondylitis. Clin Rheumatol 2011;30:361–7. 10.1007/s10067-010-1669-y - DOI - PubMed

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