Improvements in productivity at paid work and within the household, and increased participation in daily activities after 24 weeks of certolizumab pegol treatment of patients with psoriatic arthritis: results of a phase 3 double-blind randomised placebo-controlled study

Abstract

Objectives: To evaluate the effect of certolizumab pegol (CZP) on productivity outside and within the home, and on participation in family, social and leisure activities in adult patients with psoriatic arthritis (PsA).

Methods: RAPID-PsA (NCT01087788) is a phase 3, double-blind, placebo-controlled trial. 409 patients with active PsA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). The arthritis-specific Work Productivity Survey (WPS) assessed the impact of PsA on paid work and household productivity, and participation in social activities during the preceding month. WPS responses were compared between treatment arms using a non-parametric bootstrap-t method.

Results: At baseline, 56.6%, 60.1% and 61.5% of placebo, CZP 200 mg Q2W and CZP 400 mg Q4W patients were employed. By week 24, employed CZP patients reported an average of 1.0-1.8 and 3.0-3.9 fewer days of absenteeism and presenteeism, respectively, per month compared with 1.0 and 0.3 fewer days for placebo patients (p<0.05). Within the home, by week 24, CZP patients reported an average of 3.0-3.5 household work days gained per month versus 1.0 day for placebo (p<0.05). CZP patients also reported fewer days with reduced household productivity or days lost for participation in family, social and leisure activities. Improvements with CZP were seen as early as week 4 and continued to week 24.

Conclusions: CZP treatment significantly improved productivity at paid work and within the home, and resulted in greater participation in social activities for PsA patients.

Trial registration number: NCT01087788.

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Figures

Figure 1

RAPID-PsA: employment status at study baseline (randomised set population, observed cases). Other non-employed includes: student, unable to work due to non-arthritis and other non-employed status. CZP, certolizumab pegol; PBO, placebo; Q2W, every 2 weeks; Q4W, every 4 weeks.

Figure 2

RAPID-PsA: monthly improvements in paid work productivity (employed patients, randomised set population). Left hand panels represent work productivity outcomes up to week 24, right hand panels represent frequency distribution plots at baseline (BL), week 4 and week 24. Non-parametric bootstrap-t test, last observation carried forward. *Certolizumab pegol (CZP) 200 mg Q2W vs placebo (PBO) p-value ≤0.05; ‡CZP 400 mg Q4W vs PBO p-value <0.05; †0–10 point scale (0=no interference, 10=complete interference).

Figure 3

RAPID-PsA: monthly improvements in productivity within the household and in family, social and leisure activities (randomised set population). Left hand panels represent work productivity outcomes up to week 24, right hand panels represent frequency distribution plots at baseline (BL), week 4 and week 24. Non-parametric bootstrap-t test, last observation carried forward. *Certolizumab pegol (CZP) 200 mg Q2W vs placebo (PBO) p-value ≤0.05; ‡CZP 400 mg Q4W vs PBO p-value <0.05; †0–10 point scale (0=no interference, 10=complete interference).