Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


A Faster Clinical Response to Certolizumab Pegol Treatment Is Associated with Better Improvements in Household Productivity in Patients with Rheumatoid Arthritis

Westhovens1,  R., Strand2,  Vibeke, Keystone3,  Edward C., Purcaru4,  O., Khanna5,  D., Smolen6,  J. S., Kavanaugh7,  A.

UZ Gasthuisberg, KU Leuven, Leuven, Belgium
Stanford University, Portola Valley, CA
Professor of Medicine/University of Toronto, Toronto, ON
UCB, Brussels, Belgium
UCLA, Los Angeles, CA
Medical Univ Vienna, Vienna, Austria
UCSD, San Diego, CA

Purpose:

Certolizumab pegol (CZP), a PEGylated Fab' anti-TNF approved for the treatment of rheumatoid arthritis (RA), has been shown to provide rapid improvements in RA signs and symptoms and disease activity, as well as improvements in productivity at work and home, when added to methotrexate (MTX). The objective of our analysis was to determine if a more rapid clinical response to CZP treatment was associated with better long-term improvements in household productivity in patients with active RA.

Methods:

Data from patients treated with CZP 200 or 400 mg + MTX in RAPID 1 were pooled for analysis. Patients who achieved response at Week (Wk) 12 were divided into subgroups depending on response at Wk 6: Wk 6 responders and Wk 12 responders (ie, those who were non-responders at Wk 6). Responder definitions were based on ACR20 response or DAS28 decrease >=1.2 points from baseline (BL). The number of household days lost due to RA, days with productivity reduced by >=50%, the rate of RA interference with household productivity, and days lost of social activities in the last month were compared between responder subgroups using a repeated measures negative binomial regression adjusted for BL score and demographic variables. Analysis of work productivity was not possible due to an imbalance in patient numbers between the Wk 6 and Wk 12 responder groups.

Results:

BL demographics were similar between the 2 responder subgroups. Wk 6 DAS28 and ACR20 responders lost significantly fewer days of household work than Wk 12 responders from Wks 4 to Wk 52 (Table). Wk 6 responders also had fewer days with reduced household productivity and a lower rate of RA interference with household productivity.

Table. Household productivity in Wk 6 versus Wk 12 responders at Baseline, Wk 4, and Wk 52

 # Household days losta# Household days with reduced productivitya# Family, social, leisure days missedaRate of RA interferenceb (0–10)
Responder definitionBLWk4Wk52BLWk4Wk52BLWk4Wk52BLWk4Wk52
Change in DAS28 >=1.2            
Wk 6 responder (N=378)5.14.4e0.7c7.74.91.72.21.80.25.23.6d1.7d
Wk 12 responder (N=118)5.06.81.56.05.52.32.01.80.34.84.32.3
ACR 20            
Wk 6 responder (N=344)4.94.2e0.6c7.85.01.7d2.21.60.1d5.23.5c1.7c
Wk 12 responder (N=152)5.46.01.56.95.52.82.11.80.64.94.32.3
a Days in the proceeding month.b Over previous month.c P<=0.001, d P<=0.01, e P<=0.05 vs Wk 12 responders.

Conclusion:

A faster response to treatment with CZP + MTX is associated with improved household productivity in patients with active RA over 52 wks. Rapid (Wk 6) responders lost fewer days of household work and had fewer days with reduced productivity than the later (Wk 12) responders. These observations are in line with other studies highlighting the importance of a rapid response to RA treatment.

To cite this abstract, please use the following information:
Westhovens, R., Strand, Vibeke, Keystone, Edward C., Purcaru, O., Khanna, D., Smolen, J. S., et al; A Faster Clinical Response to Certolizumab Pegol Treatment Is Associated with Better Improvements in Household Productivity in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :721
DOI: 10.1002/art.25801

Abstract Supplement

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