Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Bending the Cost Curve in Early RA: Sick Leave and Disability Pension before and after Initiation of Biologics or DMARD Combination Therapy.

Neovius1,  Martin, Simard1,  Julia F., Askling2,  Johan, Group3,  ARTIS Study

Karolinska Institute, Stockholm, Sweden
Karolinska Institute


Biologic treatment is effective but expensive. Increased work force participation arguably holds the greatest potential for offsetting some of the treatment cost. It has been speculated that treatment may improve productivity in patients with RA, and early RA in particular, but long-term work ability development in this patient segment in relation to intensified anti-rheumatic treatment is not well-described.


To estimate the sick leave and disability pension trajectory over seven years in patients with early RA before and after treatment initiation with biologics or combo-DMARDs.


Patients aged 16–59 years old and a disease duration of less than five years when initiating treatment with biologics or combo-DMARDs (n=860/547; mean age 45y/46y; 76%/73% women; median RA duration 2.2y/1.2y) in 2000–2004 were identified in the Swedish Rheumatology Quality Register. For each RA case, five age-, sex-, education-, and county-matched general population comparators were sampled. Sick leave and disability pension data from 1997 to 2007 were retrieved from national registers.


During the year of treatment initiation, patients selected for biologic therapy had a mean 194 (136+59) days of sick leave and disability pension registered, compared to 159 (133+26) days in patients starting combo-DMARDs, and 52 (20+32) days in matched general population comparators. A rapid increase in annual days of sick leave and disability pension was observed before start of intensive anti-rheumatic therapy, but thereafter the number of days/year decreased for patients who had either initiated biologics or combo-DMARDs. However, the gap compared to the general population remained wide and three years after treatment start patients in the treatment groups had a mean of near or above 150 days of sick leave and disability pension registered annually.


Using seven years of real world data in patients with less than five years RA duration, rapidly increasing productivity losses were observed before initiation of intensive drug treatment. Treatment initiation was associated with a breakpoint in and small reversal of this development, but a large unmet need remained in these patients compared to general population comparators.

To cite this abstract, please use the following information:
Neovius, Martin, Simard, Julia F., Askling, Johan, Group, ARTIS Study; Bending the Cost Curve in Early RA: Sick Leave and Disability Pension before and after Initiation of Biologics or DMARD Combination Therapy. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1541
DOI: 10.1002/art.29307

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