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Newer Biological Agents in Rheumatoid Arthritis

Impact on Health-Related Quality of Life and Productivity

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Abstract

Health-related quality of life (HR-QOL) in patients with rheumatoid arthritis (RA) is significantly impaired as a result of pain, deficits in physical function and fatigue associated with this disease. Decrements in HR-QOL are also associated with an increased probability of no longer working, absence from work due to RA-associated sickness, and reduced productivity while at work or in the home, all of which have consequences for the patient as well as society. HR-QOL and productivity are thus important components in the assessment of outcomes in RA, and assessment of HR-QOL is now recommended in clinical trials that assess the efficacy of new treatments for RA. Measures to assess HR-QOL include the Medical Outcomes Study Short Form 36 (SF-36), EuroQol (EQ-5D) and the Health Utilities Index —Mark 3 (HUI3); these measures not only provide an indication of the clinical (i.e. statistical) efficacy of a treatment, but also provide information on whether this efficacy is truly ‘meaningful’ from a patient’s perspective. These measures have been utilized in clinical trials of biological agents in patients with RA, including tumour necrosis factor inhibitors (etanercept, infliximab, adalimumab, certolizumab pegol and golimumab), the co-stimulatory inhibitor molecule abatacept, the B-cell depletion agent rituximab and the inter-leukin-6 receptor antagonist tocilizumab, and have demonstrated that these agents can significantly improve HR-QOL. Assessment of work productivity in patients with RA and the impact of treatment is a practical way to measure disability from RA from individual and societal perspectives. As RA affects women three times more frequently than men, there is also a critical need for productivity assessment within the home as well as participation in family/social/leisure activities. Data from recent trials of biological agents demonstrate that these agents can reverse disease-related decrements in productivity and limitations in participation in family, social and leisure activities in patients with active RA. However, despite this recognition, several challenges in the assessment of productivity remain, including standardization of instruments. Development of additional instruments to assess HR-QOL and productivity that are easier to use in daily practice may further improve our ability to monitor the effectiveness of therapies.

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References

  1. Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet 2001; 358(9285): 903–11

    Article  PubMed  CAS  Google Scholar 

  2. Mili F, Helmick CG, Moriarty DG. Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996–99. J Rheumatol 2003; 30(1): 160–6

    PubMed  Google Scholar 

  3. Bellamy N, Boers M, Felson D, et al. Health status instruments/utilities. J Rheumatol 1995; 22(6): 1203–7

    PubMed  CAS  Google Scholar 

  4. Ware JE. SF-36 Health Survey update. Lincoln (RI): Quality Metric Incorporated, 2007

    Google Scholar 

  5. Talamo J, Frater A, Gallivan S, et al. Use of the short form 36 (SF36) for health status measurement in rheumatoid arthritis. Br J Rheumatol 1997; 36(4): 463–9

    Article  PubMed  CAS  Google Scholar 

  6. Ruta DA, Hurst NP, Kind P, et al. Measuring health status in British patients with rheumatoid arthritis: reliability, validity and responsiveness of the short form 36-item health survey (SF-36). Br J Rheumatol 1998; 37(4): 425–36

    Article  PubMed  CAS  Google Scholar 

  7. Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002; 21(2): 271–92

    Article  PubMed  Google Scholar 

  8. Crawford B, Brazier J. Evaluating direct and indirect measures of utility: stability, validity and responsiveness of the SF-6D in a rheumatoid arthritis population. Value Health 2001; 4: 71

    Google Scholar 

  9. Hurst NP, Jobanputra P, Hunter M, et al. Validity of EuroQol —a generic health status instrument —in patients with rheumatoid arthritis. Economic and Health Outcomes Research Group. Br J Rheumatol 1994; 33(7): 655–62

    CAS  Google Scholar 

  10. Hurst NP, Kind P, Ruta D, et al. Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997; 36(5): 551–9

    Article  PubMed  CAS  Google Scholar 

  11. Marra CA, Woolcott JC, Kopec JA, et al. A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc Sci Med 2005; 60(7): 1571–82

    Article  PubMed  Google Scholar 

  12. Boers M, Brooks P, Strand CV, et al. The OMERACT filter for Outcome Measures in Rheumatology. J Rheumatol 1998; 25(2): 198–9

    PubMed  CAS  Google Scholar 

  13. de Jong Z, van der HD, McKenna SP, et al. The reliability and construct validity of the RAQoL: a rheumatoid arthritis-specific quality of life instrument. Br J Rheumatol 1997; 36(8): 878–83

    Article  PubMed  Google Scholar 

  14. Russell AS. Quality-of-life assessment in rheumatoid arthritis. Pharmacoeconomics 2008; 26(10): 831–46

    Article  PubMed  CAS  Google Scholar 

  15. Wiles NJ, Scott DG, Barrett EM, et al. Benchmarking: the five year outcome of rheumatoid arthritis assessed using a pain score, the Health Assessment Questionnaire, and the Short Form-36 (SF-36) in a community and a clinic based sample. Ann Rheum Dis 2001; 60(10): 956–61

    Article  PubMed  CAS  Google Scholar 

  16. Strand V, Tugwell P, Bombardier C, et al. Function and health-related quality of life: results from a randomized controlled trial of leflunomide versus methotrexate or placebo in patients with active rheumatoid arthritis. Leflunomide Rheumatoid Arthritis Investigators Group. Arthritis Rheum 1999; 42(9): 1870–8

    CAS  Google Scholar 

  17. Strand V, Scott DL, Emery P, et al. Physical function and health related quality of life: analysis of 2-year data from randomized, controlled studies of leflunomide, sulfasalazine, or methotrexate in patients with active rheumatoid arthritis. J Rheumatol 2005; 32(4): 590–601

    PubMed  CAS  Google Scholar 

  18. FDA RA guidance document. Guidance for industry clinical development programs for drugs, devices, and biological products for the treatment of rheumatoid arthritis (RA) [online]. Available from URL: http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM071579.pdf [Accessed 2009 Dec 4]

  19. West E, Jonsson SW. Health-related quality of life in rheumatoid arthritis in Northern Sweden: a comparison between patients with early RA, patients with medium-term disease and controls, using SF-36. Clin Rheumatol 2005; 24(2): 117–22

    Article  PubMed  Google Scholar 

  20. Uhlig T, Haavardsholm EA, Kvien TK. Comparison of the Health Assessment Questionnaire (HAQ) and the modified HAQ (MHAQ) in patients with rheumatoid arthritis. Rheumatology (Oxf) 2006; 45(4): 454–8

    Article  CAS  Google Scholar 

  21. Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30(6): 473–83

    Google Scholar 

  22. Ware JE, Kosinski M. SF-36 physical and mental health summary scales: a manual for users of version 1. Boston (MA): State Quality Metric Incorporated, 2001

    Google Scholar 

  23. Ware JE. How to score version 2 of the SF-36 Health Survey. Lincoln (RI): Quality Metric Incorporated, 2000

    Google Scholar 

  24. Brazier J, Usherwood T, Harper R, et al. Deriving a preference-based single index from the UK SF-36 Health Survey. J Clin Epidemiol 1998; 51(11): 1115–28

    Article  PubMed  CAS  Google Scholar 

  25. Ara R, Brazier J. Deriving an algorithm to convert the eight mean SF-36 dimension scores into a mean EQ-5D preference-based score from published studies (where patient level data are not available). Value Health 2008; 11(7): 1131–43

    Article  PubMed  Google Scholar 

  26. Ara R, Brazier J. Predicting the Short Form-6D preference-based index using the eight mean Short Form-36 health dimension scores: estimating preference-based health-related utilities when patient level data are not available. Value Health. Epub 2008 Jul 18

  27. Coons SJ, Rao S, Keininger DL, et al. A comparative review of generic quality-of-life instruments. Pharmaco-economics 2000; 17(1): 13–35

    Article  CAS  Google Scholar 

  28. Brazier J, Roberts J, Tsuchiya A, et al. A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 2004; 13(9): 873–84

    Article  PubMed  Google Scholar 

  29. van Riel PL, Freundlich B, MacPeek D, et al. Patient-reported health outcomes in a trial of etanercept monotherapy versus combination therapy with etanercept and methotrexate for rheumatoid arthritis: the ADORE trial. Ann Rheum Dis 2008; 67(8): 1104–10

    Article  PubMed  CAS  Google Scholar 

  30. Witney AG, Treharne GJ, Tavakoli M, et al. The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis. Rheumatology (Oxf) 2006; 45(8): 975–81

    Article  CAS  Google Scholar 

  31. Ariza-Ariza R, Hernandez-Cruz B, Carmona L, et al. Assessing utility values in rheumatoid arthritis: a comparison between time trade-off and the EuroQol. Arthritis Rheum 2006; 55(5): 751–6

    Article  PubMed  Google Scholar 

  32. Marra CA, Esdaile JM, Guh D, et al. A comparison of four indirect methods of assessing utility values in rheumatoid arthritis. Med Care 2004; 42(11): 1125–31

    Article  PubMed  Google Scholar 

  33. Boyle MH, Furlong W, Feeny D, et al. Reliability of the Health Utilities Index —Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual Life Res 1995; 4(3): 249–57

    Article  PubMed  CAS  Google Scholar 

  34. Samsa G, Edelman D, Rothman ML, et al. Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999; 15(2): 141–55

    Article  PubMed  CAS  Google Scholar 

  35. Uhlig T, Smedstad LM, Vaglum P, et al. The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up. Rheumatology (Oxf) 2000; 39(7): 732–41

    Article  CAS  Google Scholar 

  36. Young A, Dixey J, Cox N, et al. How does functional disability in early rheumatoid arthritis (RA) affect patients and their lives? Results of 5 years of follow-up in 732 patients from the Early RA Study (ERAS). Rheumatology (Oxf) 2000; 39(6): 603–11

    Article  CAS  Google Scholar 

  37. Scott DL, Smith C, Kingsley G. Joint damage and disability in rheumatoid arthritis: an updated systematic review. Clin Exp Rheumatol 2003; 21 (5 Suppl. 31): S20–7

    PubMed  CAS  Google Scholar 

  38. Guyatt GH, Juniper EF, Walter SD, et al. Interpreting treatment effects in randomised trials. BMJ 1998; 316(7132): 690–3

    Article  PubMed  CAS  Google Scholar 

  39. Revicki D, Hays RD, Cella D, et al. Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 2008; 61(2): 102–9

    Article  PubMed  Google Scholar 

  40. Kosinski M, Zhao SZ, Dedhiya S, et al. Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis. Arthritis Rheum 2000; 43(7): 1478–87

    Article  PubMed  CAS  Google Scholar 

  41. Strand V, Bombardier C, Maetzel A. Use of minimum clinically important differences [MCID] in evaluating patient responses to treatment of RA [abstract]. Arthritis Rheum 2001; 44: S187

    Google Scholar 

  42. Strand V, Cannon G, Cohen S. Correlation of HAQ with SF-36; comparison of leflunomide to methotrexate in patients with active RA [abstract]. Arthritis Rheum 2001; 44: S187

    Google Scholar 

  43. Zhao SZ, Fiechtner JI, Tindall EA, et al. Evaluation of health-related quality of life of rheumatoid arthritis patients treated with celecoxib. Arthritis Care Res 2000; 13(2): 112–21

    Article  PubMed  CAS  Google Scholar 

  44. Tugwell P, Wells G, Strand V, et al. Clinical improvement as reflected in measures of function and health-related quality of life following treatment with leflunomide compared with methotrexate in patients with rheumatoid arthritis: sensitivity and relative efficiency to detect a treatment effect in a twelve-month, placebo-controlled trial. Leflunomide Rheumatoid Arthritis Investigators Group. Arthritis Rheum 2000; 43(3): 506–14

    CAS  Google Scholar 

  45. Strand V, Crawford B. Improvement in health-related quality of life in patients with systemic lupus erythematosus following sustained reductions in anti-dsDNA antibodies. Exp Rev Pharmacoecon Outcomes Res 2006; 5: 317–26

    Article  Google Scholar 

  46. Kosinski M, Kujawski SC, Martin R, et al. Health-related quality of life in early rheumatoid arthritis: impact of disease and treatment response. Am J Manag Care 2002; 8(3): 231–40

    PubMed  Google Scholar 

  47. Weisman MH, Strand V, Cifaldi M. Adalimumab plus methotrexate is superior to MTX alone in improving physical function, as measured by the SF-36, in patients with early rheumatoid arthritis [abstract]. Arthritis Rheum 2005; 52: S395

    Article  CAS  Google Scholar 

  48. Russell AS, Wallenstein GV, Li T, et al. Abatacept improves both the physical and mental health of patients with rheumatoid arthritis who have inadequate response to methotrexate treatment. Ann Rheum Dis 2007; 66(2): 189–94

    Article  PubMed  CAS  Google Scholar 

  49. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003; 41(5): 582–92

    PubMed  Google Scholar 

  50. Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 2008; 9(2): 105–21

    Article  PubMed  Google Scholar 

  51. Moore RA, Moore OA, Derry S, et al. Responder analysis for pain relief and numbers needed to treat in a meta-analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Ann Rheum Dis. Epub 2009 Apr 12

  52. Strand V, Crawford B, Singh J, et al. Use of “spydergrams” to present and interpret SF-36 health related quality of life data across rheumatic diseases. Ann Rheum Dis 2009; 68: 1800–4

    Article  PubMed  CAS  Google Scholar 

  53. Maini RN, Breedveld FC, Kalden JR, et al. Sustained improvement over two years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate. Arthritis Rheum 2004; 50(4): 1051–65

    Article  PubMed  CAS  Google Scholar 

  54. Strand V, Latham CEP. Health-related quality-of-life measures and analyses in rheumatic diseases. Cont Topics Rheum Arth 2009; 3: 5–11

    Google Scholar 

  55. Kekow J, Moots RJ, Emery P, et al. Patient-reported outcomes improve with etanercept plus methotrexate in active early rheumatoid arthritis and the improvement is strongly associated with remission: The COMET trial. Ann Rheum Dis 2010 Jan; 69(1): 222–5

    Article  PubMed  CAS  Google Scholar 

  56. Strand V, Keininger DL, Kavanaugh A. Certolizumab pegol (CZP) induces rapid and sustained clinically meaningful improvements in physical function and health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA): the RAPID 1 and 2 randomised clinical trials (RCTS) [abstract]. Ann Rheum Dis 2008; 67(SII): 331

    Google Scholar 

  57. Strand V, Mease P, Burmester GR, et al. Rapid and sustained improvements in health-related quality of life, fatigue, and other patient-reported outcomes in rheumatoid arthritis patients treated with certolizumab pegol plus methotrexate over 1 year: results from the RAPID 1 randomized controlled trial. Arthritis Res Ther 2009 Nov 12; 11(6): R170

    Article  PubMed  CAS  Google Scholar 

  58. sanofi aventis. Welcome to arrive: your Arava® care programme [online]. Available from URL: http://www.arrive-online.org [Accessed 2009 Dec 4]

  59. Harrison MJ, Tricker KJ, Davies L, et al. The relationship between social deprivation, disease outcome measures, and response to treatment in patients with stable, longstanding rheumatoid arthritis. J Rheumatol 2005; 32(12): 2330–6

    PubMed  Google Scholar 

  60. Aletaha D, Strand V, Smolen JS, et al. Treatment-related improvement in physical function varies with duration of rheumatoid arthritis: a pooled analysis of clinical trial results. Ann Rheum Dis 2008; 67(2): 238–43

    Article  PubMed  CAS  Google Scholar 

  61. Amjadi SS, Maranian PM, Paulus HE, et al. Validating and assessing the sensitivity of the Health Assessment Questionnaire-Disability Index-derived Short Form-6D in patients with early aggressive rheumatoid arthritis. J Rheumatol 2009; 36(6): 1150–7

    Article  PubMed  Google Scholar 

  62. Scott DL, Khoshaba B, Choy EH, et al. Limited correlation between the Health Assessment Questionnaire (HAQ) and EuroQol in rheumatoid arthritis: questionable validity of deriving quality adjusted life years from HAQ. Ann Rheum Dis 2007; 66(11): 1534–7

    Article  PubMed  CAS  Google Scholar 

  63. Strand V. Longer term benefits of treating rheumatoid arthritis: assessment of radiographic damage and physical function in clinical trials. Clin Exp Rheumatol 2004; 22 (5 Suppl. 35): S57–64

    PubMed  CAS  Google Scholar 

  64. Strand V, Singh JA. Improved health-related quality of life with effective disease-modifying antirheumatic drugs: evidence from randomized controlled trials. Am J Manag Care 2008; 14(4): 234–54

    PubMed  Google Scholar 

  65. Strand V, Singh JA. Health related quality of life in rheumatoid arthritis. In: Hochberg MC, Silman A, Smolen J, et al., editors. Rheumatoid Arthritis. Philadelphia (PA): Mosby Elsevier, 2008: 237–59

    Google Scholar 

  66. Han C, Smolen JS, Kavanaugh A, et al. The impact of infliximab treatment on quality of life in patients with inflammatory rheumatic diseases. Arthritis Res Ther 2007; 9(5): R103

    Article  PubMed  CAS  Google Scholar 

  67. Smolen JS, Han C, van der HD, et al. Infliximab treatment maintains employability in patients with early rheumatoid arthritis. Arthritis Rheum 2006; 54(3): 716–22

    Article  PubMed  CAS  Google Scholar 

  68. Strand V, Weinblatt M, Keystone E. Treatment with adalimumab (D2E7), a fully human anti-TNF monoclonal antibody, improves physical function and health related quality of life (HRQOL) in patients with active rheumatoid arthritis (RA) [abstract]. Ann Rheum Dis 2002; 62(SII): 175

    Google Scholar 

  69. Keystone EC, Kavanaugh AF, Sharp JT, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial. Arthritis Rheum 2004; 50(5): 1400–11

    Article  PubMed  CAS  Google Scholar 

  70. Fleischmann R, Vencovsky J, van Vollenhoven R, et al. Efficacy and safety of certolizumab pegol monotherapy every 4 weeks in patients with rheumatoid arthritis failing previous disease-modifying antirheumatic therapy: the FAST4WARD study. Ann Rheum Dis 2009; 68(6): 805–11

    Article  PubMed  CAS  Google Scholar 

  71. Strand V, Keininger DL, Tahari-Fitzgerald E, et al. Certolizumab pegol monotherapy 400 mg every 4 weeks improves health-related quality of life and relieves fatigue in patients with rheumatoid arthritis who have previously failed DMARD therapy [abstract]. Ann Rheum Dis 2007; 66 Suppl. iii: 188

    Google Scholar 

  72. Keystone E, van der Heijde D, Mason D, et al. Certolizumab pegol plus methotrexate is significantly more effective than placebo plus methotrexate in active rheumatoid arthritis: findings of a fifty-two-week, phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheum 2008; 58(11): 3319–29

    Article  PubMed  CAS  Google Scholar 

  73. Strand V, Coteur G, Keininger DL. Health-related quality of life and fatigue benefits in rheumatoid arthritis patients were sustained over 2 years of treatment with certolizumab pegol [abstract]. Arthritis Rheum 2008; 57 Suppl.: 975

    Google Scholar 

  74. Strand V, Keininger DL, Tahiri-Fitzgerald E. Certolizumab pegol results in clinically meaningful improvements in physical function and health-related quality of life in patients with active rheumatoid arthritis despite treatment with methotrexate [abstract]. Arthritis Rheum 2007; 56 Suppl.: 393

    Article  Google Scholar 

  75. Smolen JS, Landewe R, Mease P, et al. Efficacy and safety of certolizumab pegol plus methotrexate in active rheumatoid arthritis: the RAPID 2 study. A randomised controlled trial. Ann Rheum Dis 2009; 68(6): 797–804

    CAS  Google Scholar 

  76. Emery P, Kosinski M, Li T, et al. Treatment of rheumatoid arthritis patients with abatacept and methotrexate significantly improved health-related quality of life. J Rheumatol 2006; 33(4): 681–9

    PubMed  CAS  Google Scholar 

  77. Kremer JM, Genant HK, Moreland LW, et al. Results of a two-year followup study of patients with rheumatoid arthritis who received a combination of abatacept and methotrexate. Arthritis Rheum 2008; 58(4): 953–63

    Article  PubMed  CAS  Google Scholar 

  78. Westhovens R, Cole JC, Li T, et al. Improved health-related quality of life for rheumatoid arthritis patients treated with abatacept who have inadequate response to anti-TNF therapy in a double-blind, placebo-controlled, multicentre randomized clinical trial. Rheumatology (Oxf) 2006; 45(10): 1238–46

    Article  CAS  Google Scholar 

  79. Emery P, Fleischmann R, Filipowicz-Sosnowska A, et al. The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double-blind, placebo-controlled, dose-ranging trial. Arthritis Rheum 2006; 54(5): 1390–400

    Article  PubMed  CAS  Google Scholar 

  80. Mease PJ, Revicki DA, Szechinski J, et al. Improved health-related quality of life for patients with active rheumatoid arthritis receiving rituximab: results of the Dose-Ranging Assessment: International Clinical Evaluation of Rituximab in Rheumatoid Arthritis (DANCER) Trial. J Rheumatol 2008; 35(1): 20–30

    PubMed  CAS  Google Scholar 

  81. Keystone E, Burmester GR, Furie R, et al. Improvement in patient-reported outcomes in a rituximab trial in patients with severe rheumatoid arthritis refractory to anti-tumor necrosis factor therapy. Arthritis Rheum 2008; 59(6): 785–93

    Article  PubMed  CAS  Google Scholar 

  82. Smolen J, Rovensky J, Ramos-Remus C, et al. Targeting the IL-6 receptor with the monoclonal antibody tocilizumab significantly improves quality of life in patients with rheumatoid arthritis [abstract]. Arthritis Rheum 2007; 56 Suppl.: 292

    Google Scholar 

  83. Gomez-Reino J, Fairfax MJ, Pavelka K, et al. Targeted inhibition of IL-6 signalling with tocilizumab improves quality of life and function in patients with rheumatoid arthritis with inadequate response to a range of DMARDs [abstract]. Arthritis Rheum 2007; 56: S522; L6

    Google Scholar 

  84. Kremer J, Pope J, Tony H-P, et al. Tocilizumab (TCZ) improves quality of life (QOL) in patients with rheumatoid arthritis (RA) who had inadequate response (IR) to TNF antagonists [abstract]. Arthritis Rheum 2008; 5 Suppl.: 991

    Google Scholar 

  85. Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000; 343(22): 1594–602

    Article  PubMed  CAS  Google Scholar 

  86. Durez P, Nzeusseu TA, Lauwerys BR, et al. A randomised comparative study of the short term clinical and biological effects of intravenous pulse methylprednisolone and infliximab in patients with active rheumatoid arthritis despite methotrexate treatment. Ann Rheum Dis 2004; 63(9): 1069–74

    Article  PubMed  CAS  Google Scholar 

  87. Mathias SD, Colwell HH, Miller DP, et al. Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000; 22(1): 128–39

    Article  PubMed  CAS  Google Scholar 

  88. van der Heijde D, Klareskog L, Singh A, et al. Patient reported outcomes in a trial of combination therapy with etanercept and methotrexate for rheumatoid arthritis: the TEMPO trial. Ann Rheum Dis 2006; 65(3): 328–34

    Article  PubMed  CAS  Google Scholar 

  89. Mittendorf T, Dietz B, Sterz R, et al. Improvement and longterm maintenance of quality of life during treatment with adalimumab in severe rheumatoid arthritis. J Rheumatol 2007; 34(12): 2343–50

    PubMed  CAS  Google Scholar 

  90. Kimel M, Cifaldi M, Chen N, et al. Adalimumab plus methotrexate improved SF-36 scores and reduced the effect of rheumatoid arthritis (RA) on work activity for patients with early RA. J Rheumatol 2008; 35(2): 206–15

    PubMed  CAS  Google Scholar 

  91. Kay J, Matteson EL, Dasgupta B, et al. Golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate: a randomized, double-blind, placebo-controlled, dose-ranging study. Arthritis Rheum 2008; 58(4): 964–75

    Article  PubMed  CAS  Google Scholar 

  92. Keystone EC, Genovese MC, Klareskog L, et al. Golimumab, a human antibody to tumour necrosis factor (alpha) given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate therapy: the GO-FORWARD Study. Ann Rheum Dis 2009; 68(6): 789–96

    Article  PubMed  CAS  Google Scholar 

  93. Smolen JS, Kay J, Doyle MK, et al. Golimumab in patients with active rheumatoid arthritis after treatment with tumour necrosis factor alpha inhibitors (GO-AFTER study): a multicentre, randomised, double-blind, placebo-controlled, phase III trial. Lancet 2009; 374(9685): 210–21

    Article  PubMed  CAS  Google Scholar 

  94. Michaud K, Bombardier C, Emery P. Quality of life in patients with rheumatoid arthritis: does abatacept make a difference? [abstract]. Clin Exp Rheumatol 2007; 25 (5 Suppl. 46): S35–45

    PubMed  CAS  Google Scholar 

  95. Weinblatt M, Schiff M, Goldman A, et al. Selective costi-mulation modulation using abatacept in patients with active rheumatoid arthritis while receiving etanercept: a randomised clinical trial. Ann Rheum Dis 2007; 66(2): 228–34

    Article  PubMed  CAS  Google Scholar 

  96. Hazes JM, Geuskens GA, Burdorf A. Work limitations in the outcome assessment of rheumatoid arthritis. J Rheumatol 2005; 32(6): 980–2

    PubMed  Google Scholar 

  97. Brouwer WB, Meerding WJ, Lamers LM, et al. The relationship between productivity and health-related QOL: an exploration. Pharmacoeconomics 2005; 23(3): 209–18

    Article  PubMed  Google Scholar 

  98. Verstappen SM, Boonen A, Bijlsma JW, et al. Working status among Dutch patients with rheumatoid arthritis: work disability and working conditions. Rheumatology (Oxf) 2005; 44(2): 202–6

    Article  CAS  Google Scholar 

  99. Merkesdal S, Huelsemann JL, Mittendorf T, et al. Productivity costs of rheumatoid arthritis in Germany. Cost composition and prediction of main cost components. Z Rheumatol 2006; 65(6): 527–34

    CAS  Google Scholar 

  100. Burton W, Morrison A, MacLean R, et al. Systematic review of studies of productivity loss due to rheumatoid arthritis. Occup Med (Lond) 2006; 56(1): 18–27

    Article  Google Scholar 

  101. Wolfe F, Michaud K, Choi HK, et al. Household income and earnings losses among 6,396 persons with rheumatoid arthritis. J Rheumatol 2005; 32(10): 1875–83

    PubMed  Google Scholar 

  102. Singh G, Terry R, Ramey D, et al. Long-term medical costs and outcomes are significantly associated with early changes in disability in rheumatoid arthritis [abstract]. Arthritis Rheum 1996; 39: S318

    Google Scholar 

  103. Han C, Smolen J, Kavanaugh A, et al. Comparison of employability outcomes among patients with early or long-standing rheumatoid arthritis. Arthritis Rheum 2008; 59(4): 510–4

    Article  PubMed  Google Scholar 

  104. Puolakka K, Kautiainen H, Mottonen T, et al. Early suppression of disease activity is essential for maintenance of work capacity in patients with recent-onset rheumatoid arthritis: five-year experience from the FIN-RACo trial. Arthritis Rheum 2005; 52(1): 36–41

    Article  PubMed  Google Scholar 

  105. Yelin E, Trupin L, Katz P, et al. Association between eta-nercept use and employment outcomes among patients with rheumatoid arthritis. Arthritis Rheum 2003; 48(11): 3046–54

    Article  PubMed  Google Scholar 

  106. Mittendorf T, Dietz B, Sterz R, et al. Personal and economic burden of late-stage rheumatoid arthritis among patients treated with adalimumab: an evaluation from a patient’s perspective. Rheumatology (Oxf) 2008; 47(2): 188–93

    Article  CAS  Google Scholar 

  107. Kimel M, Cifaldi M, Chmiel J. Relationship between health-related quality of life and employment outcomes during adalimumab (ADA) plus methotrexate (MTX) combination therapy versus MTX monotherapy in patients with early rheumatoid arthritis [abstract]. Arthritis Rheum 2007; 56: S89

    Article  CAS  Google Scholar 

  108. Bejarano V, Quinn M, Conaghan PG, et al. Improved work stability and reduced job loss with adalimumab plus methotrexate in early rheumatoid arthritis: results of the Prevention Of Work Disability (PROWD) study [abstract]. Ann Rheum Dis 2007; 66 Suppl. II: 176

    Google Scholar 

  109. Halpern MT, Cifaldi MA, Kvien TK. Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group. Ann Rheum Dis 2009; 68(6): 930–7

    Article  PubMed  CAS  Google Scholar 

  110. Osterhaus JT, Purcaru O, Richard L. Discriminant validity, responsiveness and reliability of the rheumatoid arthritis-specific Work Productivity Survey (WPS-RA) [abstract]. Arthritis Res Ther 2009; 11(3): R73

    Article  PubMed  Google Scholar 

  111. Strand V, Brown M, Purcaru O. Certolizumab pegol monotherapy improves productivity in patients with active rheumatoid arthritis: results from a phase III randomized controlled trial [abstract]. Ann Rheum Dis 2007; 66 Suppl. II: 274

    Google Scholar 

  112. Kavanaugh A, Smolen J, Emery P, et al. Effect of certolizumab pegol with methotrexate on home and work place productivity and social activities in patients with active rheumatoid arthritis. Arthritis Rheum 2009; 61(11): 1592–600

    Article  PubMed  CAS  Google Scholar 

  113. Cole JC, Li T, Lin P, et al. Treatment impact on estimated medical expenditure and job loss likelihood in rheumatoid arthritis: re-examining quality of life outcomes from a randomized placebo-controlled clinical trial with abata-cept. Rheumatology (Oxf) 2008; 47(7): 1044–50

    Article  CAS  Google Scholar 

  114. Escorpizo R, Bombardier C, Boonen A, et al. Worker productivity outcome measures in arthritis. J Rheumatol 2007; 34(6): 1372–80

    PubMed  Google Scholar 

  115. Verstappen SM, Boonen A, Verkleij H, et al. Productivity costs among patients with rheumatoid arthritis: the influence of methods and sources to value loss of productivity. Ann Rheum Dis 2005; 64(12): 1754–60

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

There was no funding provided for the study or preparation of this article. All literature review, analyses and interpretation of data and preparation of this article is solely the work of Drs Strand and Singh. Drs Strand and Singh have both declared receiving honoraria and research grants from several companies involved in RA research.

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Correspondence to Vibeke Strand.

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Strand, V., Singh, J.A. Newer Biological Agents in Rheumatoid Arthritis. Drugs 70, 121–145 (2010). https://doi.org/10.2165/11531980-000000000-00000

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