Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy: a population-based regional cohort study from southern Sweden

TY - JOUR

T1 - Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy

T2 - a population-based regional cohort study from southern Sweden

AU - Wallman, Johan K

AU - Jöud, Anna

AU - Olofsson, Tor

AU - Jacobsson, Lennart T H

AU - Bliddal, Henning

AU - Kristensen, Lars E

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objective.: The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA).Methods.: Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends.Results.: The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout.Conclusion.: Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up.

AB - Objective.: The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA).Methods.: Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends.Results.: The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout.Conclusion.: Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up.

KW - Aged

KW - Anti-Inflammatory Agents, Non-Steroidal

KW - Axis, Cervical Vertebra

KW - Disabled Persons

KW - Etanercept

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Occupational Diseases

KW - Sick Leave

KW - Spondylarthritis

KW - Sweden

KW - Tumor Necrosis Factor-alpha

KW - Journal Article

KW - Multicenter Study

KW - Randomized Controlled Trial

U2 - 10.1093/rheumatology/kew473

DO - 10.1093/rheumatology/kew473

M3 - Journal article

C2 - 28064208

SN - 1462-0324

VL - 56

SP - 716

EP - 724

JO - Rheumatology

JF - Rheumatology

IS - 5

ER -