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Effect of Infliximab Therapy on Employment,
Time Lost from Work, and Productivity in Patients with Psoriatic Arthritis
ARTHUR KAVANAUGH, CHRISTIAN ANTONI, PHILIP MEASE, DAFNA GLADMAN, SONGKAI YAN, MOHAN BALA, BEI ZHOU, LISA T. DOOLEY, ANNA BEUTLER, CYNTHIA GUZZO, and GERALD G. KRUEGER ABSTRACT. Objective. To examine the effect of infliximab on employment status, time lost from work, and productivity in a double-blind, placebo-controlled study of patients with active psoriatic arthritis (PsA). Methods. Two hundred adult patients with PsA were randomized to intravenous infusions of either infliximab 5 mg/kg or placebo at Weeks 0, 2, 6, 14, and 22, with early escape at Week 16. Employment status, workdays missed, and productivity were assessed at baseline and at Week 14. The effect of PsA on daily productivity was assessed using a visual analog scale. Results. At baseline, similar percentages of patients in both treatment groups were employed and similar percentages missed workdays; the mean productivity score at baseline was similar between groups (roughly 3 on a scale of 0 to 10). At Week 14, median productivity increased significantly in the infliximab group compared with the placebo group (67.5% vs 9.2%; p < 0.0001). Compared with the placebo group, higher proportions of patients in the infliximab group improved employment status from unemployed at baseline to employed at Week 14 (11.5% vs 0%; p = 0.084) and from part-time to full-time employment (30.0% vs 10.0%; p = 0.582). Among patients employed at baseline and Week 14, a lower proportion of patients in the infliximab group than in the placebo group had missed workdays in the 4 weeks prior to Week 14 (p = 0.138). Conclusion. After 14 weeks of treatment, infliximab improved productivity in patients with active PsA. There was also a trend toward increased employment and reduced time lost from work for patients treated with infliximab. (First Release Sept 1 2006; J Rheumatol 2006;33:2254-9) Key Indexing Terms:
PSORIATIC ARTHRITIS From the Division of Rheumatology, Allergy, and Immunology, University of California at San Diego, San Diego, California; Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Schering-Plough, Kenilworth, New Jersey; Swedish Medical Center, Seattle, Washington; University of Toronto, Toronto, Ontario, Canada; Centocor, Inc., Malvern, Pennsylvania; and University of Utah Health Sciences Center, Salt Lake City, Utah, USA. The IMPACT 2 study was funded by Centocor, Inc., Malvern, Pennsylvania, and Schering-Plough, Kenilworth, New Jersey, USA. A. Kavanaugh, MD, Division of Rheumatology, Allergy, and Immunology, University of California at San Diego; C. Antoni, MD, Friedrich Alexander University Erlangen-Nürnberg (currently affiliated with Schering-Plough, Kenilworth, NJ, USA); P. Mease, MD, Swedish Medical Center; D. Gladman, MD, University of Toronto; S. Yan, MS; M. Bala, PhD; B. Zhou, PhD; L.T. Dooley, DrPH; A. Beutler, MD; C. Guzzo, MD, Centocor, Inc; G.G. Krueger, MD, University of Utah Health Sciences Center. Address reprint requests to Dr. A. Kavanaugh, Center for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0943. E-mail: akavanaugh@ucsd.edu Accepted for publication May 3, 2006.
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