Effectiveness and Safety of Etanercept in Patients with Psoriatic Arthritis in a Canadian Clinical Practice Setting: The REPArE Trial

Abstract

Objective.To describe the longterm effectiveness and safety of etanercept in Canadian patients with psoriatic arthritis (PsA), treated over 24 months in clinical practice.Methods.Patients with active PsA (≥ 3 tender and ≥ 3 swollen joints) were recruited from 22 centers. Etanercept was administered at 50 mg/week subcutaneously. In addition to clinical assessment of skin and joint disease, conducted at baseline and at Months 6, 12, 18, and 24, regular patient interviews were conducted by telephone. Patient responses related to health status, disability, and work productivity were scored using the patient global assessment tool, the Health Assessment Questionnaire (HAQ), the Health and Labour Questionnaire (HLQ), and the Fatigue Severity Scale.Results.Out of 110 patients, 71 (65%) maintained etanercept treatment through the end of our study. All clinical measures of disease severity, including joint tenderness/pain, joint swelling, and Psoriasis Area and Severity Index score, improved significantly between baseline and Month 6 of etanercept treatment and remained constant thereafter. By the end of our study, 79% of patients achieved a Psoriatic Arthritis Response Criteria response, and 56% of patients achieved a 0.5-point improvement on HAQ, indicating clinically significant improvement in disability; 14% of patients finished our study free of disability (HAQ = 0). Patients’ work productivity and fatigue improved significantly in parallel with these clinical and functional improvements.Conclusion.Continuous treatment with etanercept over 2 years in a clinical setting improved clinical symptoms of PsA while reducing fatigue, improving work productivity, and ameliorating or eliminating disability.

Employment is maintained and sick days decreased in psoriasis/psoriatic arthritis patients with etanercept treatment

“…These data are comparable with a previous study that looked at treatment of active PsA with etanercept over 24 months [13]. Unlike the current study, those investigators observed a nonsignificant decline in missed work days (absenteeism for any reason) from 0.7 days per 2 weeks at baseline to 0.3 days per month after 2 years of treatment (p = 0.3436).…”

Consequences of inflammatory arthritis for workplace productivity loss and sick leave: a systematic review

“…Of 47 original studies, 42 included RA patients,3 11–19 21–24 26 29–40 45 46 48–53 55–64 four included psoriatic arthritis patients,20 25 27 30 two included early arthritis patients9 19 64 and three included patients with sponyloarthropathies 28 30 47. In 21 studies, RA patients satisfied the 1987 American College of Rheumatology criteria,11 13 15–17 22 23 26 32–36 41 45 46 48 51 52 54 56 60 62 in 15 studies patients were clinically diagnosed12 14 18 21 24 29 30 37–39 48 53 57–59 61 63 and in four studies patients satisfied the ICD-9 code 40 49 50 55.…”

“…A total of 11 studies reported on early RA (<2 years) 3 11–15 23 33 34 36 41 45 54 56 59 61 62. There were 11 clinical trials,11 13 25–27 32 45 51 54 56 60 19 cross-sectional articles,3 15–17 19 24 31 33–35 47 48 50 52 55 57–59 63 15 prospective cohort articles,9 18 20 22 23 29 30 36–38 46 53 61 62 64 two case control studies14 40 and four retrospective cohort studies 21 28 39 49…”

“…Self-constructed questionnaires to obtain sick leave data were used in 24 studies (51%),9 11 13 16 18 19 22 23 25–27 29 30 32 37 46–48 50 51 55 56 62–64 while nine studies used standardised questionnaires,3 12 15 20 24 52 53 59–61 seven studies (15%) used registries,14 28 38–41 45 49 one study reported physician-certified data33 34 36 and two studies conducted interviews to obtain sick leave data 17 21…”

Some Approaches to Quantitative Evaluation of Reduced Productivity in Subjects With Rheumatic Diseases

“…Gladman и соавт. [26], изучая эффективность этанерцепта у больных ПсА, определили снижение абсен-теизма по HLQ с 0,7 дня за 2 нед в начале исследования до 0,3 дня за этот же период времени через 24 мес терапии (различие, однако, не было достоверным).…”