Jak ovlivňuje biologická léčba práceschopnost u nemocných s axiální spondyloartritidou – výsledky z Českého národního registru ATTRA

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Authors: K. Pavelka ¹; Z. Křístková ²; L. Nekvindová ^2,3
Authors place of work: Revmatologický ústav, Praha ¹; Institut biostatistiky a analýz, s. r. o. ²; 1. lékařská fakulta Univerzity Karlovy, Praha ³
Published in the journal: Čes. Revmatol., 29, 2021, No. 2, p. 86-96.
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Summary

Aim. A number of studies have shown that the ability to work in patients with ankylosing spondylitis (AS) is reduced compared to the general population. Furthermore, it has also been shown that reducing disease activity by biological disease-modifying antirheumatic drugs (bDMARDs) improves the patient’s ability to work, both in paid and unpaid work. The Work Productivity and Activity Impairment Questionnaire (WPAI) is a validated indicator of work ability that has also proven itself in AS.
Methods. The aim of the study was to compare the effectiveness of biological treatment in patients with radiographic and non-radiographic axial spondyloarthritis (nr-axSpA) and also to evaluate the effect on work ability in both subsets of the disease. The study included 2599 patients with a diagnosis of AS and 333 patients with a diagnosis of nr-axSpA.
Results. Biological treatment was significantly effective. Treatment retention was 42% better in patients with ankylosing spondylitis than with non-radiographic axial spondyloarthritis. After six months of treatment, the non-radiographic subset had a lower Health Assessment Questionnaire (HAQ) and a lower Ankylosing Spondylitis Disease Activity Score (ASDAS), which were already balanced at later intervals. Some differences were found in the overall health assessment by the SF-36 (Short Form 36 Health Survey). Furthermore, the effect of disease activity and its possible reduction of the individual components of WPAI was evaluated. The mean percentage of missed working hours decreased from an initial 12.3 ± 0.8 to 3.5 ± 0.5 after 24 months of treatment in AS. Presenteeism improved by 34.5% (p < 0.001), overall reduction of activities by 36.4% (decrease from 61.5% to 25.1%, p < 0.001). A correlation of disease activity assessed by ASDAS prior to initiation of the first biologic therapy with WPAI components was also performed. ASDAS correlated highly with all components of WPAI, i.e. absenteeism, presenteeism, overall limitation of work capacity and limitation of activities. The decrease in ASDAS correlated with the decrease in all WPAI components in all evaluated intervals.
Conclusion. Treatment with bDMARDs significantly improves the ability of paid and unpaid work in both forms of axial spondyloarthritis.

Keywords:

ankylosing spondylitis – axial spondyloarthritis – biological treatment – work ability – WPAI

Zdroje

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