Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Sick Leave and Disability Pension Before and After Initiation of Biologics in Psoriatic Arthritis Patients: Four-Year Nationwide Cohort Study.

Neovius1,  Martin, Eriksson2,  Jonas, Simard2,  Julia F., Askling1,  Johan, ARTIS Study Group,  

Clinical Epidemiology Unit, Dept of Medicine, Karolinska Institutet, Solna, Sweden
Clinical Epidemiology Unit, Dept of Medicine, Karolinska Institutet, Stockholm, Sweden

Background/Purpose:

Productivity losses and biologic drugs are considered the major cost drivers in psoriatic arthritis (PsA), but long-term productivity data from PsA patients treated with biologics remain scarce. The aim of this study was to investigate changes in sick leave and disability pension in relation to start of biologic treatment in PsA patients.

Methods:

PsA patients aged 19–60y initiating their first biologic (n=1,300; mean age 45y; 52% men) were identified in the Swedish Biologics Register ARTIS between 1999 and 2008. Five general population comparators per patient were sampled using age, sex, education and start year as matching factors. Sick leave and disability pension data (1997–2010) were retrieved from the Swedish Social Insurance Agency from two years before to two years after the day of biologic treatment start.

Results:

Mean monthly days on disability pension increased monotonically from -24 months to +24 months after bio-start (5.6 to 9.4; p<0.001; Figure) with 25% and 39% on disability pension at the respective time points. The difference compared to the general population was large and increased from a mean of 3.6 to 6.7 days/month (Dmean 3.1; p<0.001), while the disability pension prevalence ratio increased from 3.5 to 4.0. Mean monthly sick leave days increased from 5.2 at -24 months to 7.7 at bio-start, but then decreased to 3.3 at +24 months. Mean total days of sick leave and disability pension was 14.9 at bio-start, significantly higher than at both -24 and +24 months (10.8 and 12.7 days, respectively; both p<0.001). The medians at -24, bio-start and +24 months were 0, 16 and 8 days/month, respectively. At bio-start the mean difference versus the general population was 11.6 total days/month (compared to 7.6 at -24 and 9.1 at +24 months). The distribution of days of sick leave and disability pension was skewed: 21% of patients accounted for >50% of total days at +24 months. Calendar period differences also existed with higher levels of sick leave and disability pension in the earlier compared to the later bio-start cohorts (Figure).

Conclusion:

Mean and median monthly sick leave and disability pension days increased before bio-start. After bio-start, productivity improved but did not fully rebound to the -24 month level and remained significantly elevated compared to the general population. A small number of patients accounted for the bulk of the productivity losses.

To cite this abstract, please use the following information:
Neovius, Martin, Eriksson, Jonas, Simard, Julia F., Askling, Johan, ARTIS Study Group, ; Sick Leave and Disability Pension Before and After Initiation of Biologics in Psoriatic Arthritis Patients: Four-Year Nationwide Cohort Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1206
DOI:

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