Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison
Objective To compare work loss after starting tumour necrosis factor inhibitors (TNFi), rituximab, abatacept or tocilizumab in patients with rheumatoid arthritis (RA).Methods We used data from the Swedish Rheumatology Quality Register to identify patients aged 19-62 years who were treated with TNFi...
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BMJ Publishing Group
2025-01-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/11/1/e004936.full |
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| author | Ulf Lindström Johan Askling Katerina Chatzidionysiou Lotta Ljung Lars Klareskog Martin Neovius Nils Feltelius Eva Baecklund Christopher Sjöwall Helena Forsblad-d’Elia Carl Turesson Elisabet Lindqvist Thomas Frisell Alf Kastbom Helena Forsblad-d'Elia Jonas Söderling Ann Knight Gerd-Marie Alenius Gustaf Magnus Bruze |
| author_facet | Ulf Lindström Johan Askling Katerina Chatzidionysiou Lotta Ljung Lars Klareskog Martin Neovius Nils Feltelius Eva Baecklund Christopher Sjöwall Helena Forsblad-d’Elia Carl Turesson Elisabet Lindqvist Thomas Frisell Alf Kastbom Helena Forsblad-d'Elia Jonas Söderling Ann Knight Gerd-Marie Alenius Gustaf Magnus Bruze |
| author_sort | Ulf Lindström |
| collection | DOAJ |
| description | Objective To compare work loss after starting tumour necrosis factor inhibitors (TNFi), rituximab, abatacept or tocilizumab in patients with rheumatoid arthritis (RA).Methods We used data from the Swedish Rheumatology Quality Register to identify patients aged 19-62 years who were treated with TNFi (n=15 093), rituximab (n=2123), abatacept (n=1877) or tocilizumab (n=1720) between 2007 and 2020. Data on work loss (0–365 days per year) from sick leave and disability pension were retrieved from linkage to the Social Insurance Agency. Patients in the different treatment arms were balanced regarding baseline covariates using inverse probability weighting (IPTW).Results Work loss increased for patients with RA until drug treatment initiation, reached a peak in the month after treatment initiation and then levelled off. Following IPTW, at 3 years before starting the treatment, there were no statistically significant differences in the mean annual adjusted work loss days between rituximab, abatacept or tocilizumab vs TNFi (mean difference vs TNFi: rituximab 1.1 days, 95% CI −4.5 to 6.7; abatacept 3.3, 95% CI −2.6 to 9.2; tocilizumab 1.2, 95% CI −4.9 to 7.3). At 3 years after starting the treatment (latest January 2021), there were also no statistically significant differences in the mean annual adjusted work loss days (mean difference: rituximab −4.8 days, 95% CI −11.3 to 1.7; abatacept 5.3, 95% CI −1.8 to 12.3; tocilizumab −0.6, 95% CI −7.7 to 6.5).Conclusions Taking channelling into account, patients with RA treated with TNFi, rituximab, abatacept or tocilizumab had similar trajectories of work loss from sick leave and disability pension until treatment initiation, and similar trend breaks and plateau 3 years thereafter. |
| format | Article |
| id | doaj-art-07d54228cebb4727afc2fefc3e643973 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-07d54228cebb4727afc2fefc3e6439732025-01-31T20:55:08ZengBMJ Publishing GroupRMD Open2056-59332025-01-0111110.1136/rmdopen-2024-004936Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparisonUlf LindströmJohan Askling0Katerina ChatzidionysiouLotta LjungLars KlareskogMartin Neovius1Nils FelteliusEva BaecklundChristopher SjöwallHelena Forsblad-d’EliaCarl Turesson2Elisabet LindqvistThomas Frisell3Alf KastbomHelena Forsblad-d'Elia4Jonas Söderling5Ann KnightGerd-Marie AleniusGustaf Magnus Bruze6Clinical Epidemiology Division, Dept of Medicine, Karolinska Institutet, Stockholm, SwedenClinical Epidemiology Division, Dept of Medicine, Karolinska Institutet, Stockholm, SwedenRheumatology, Dept of Clinical Sciences, Malmö, Lund University, Malmö, SwedenClinical Epidemiology Division, Dept of Medicine, Karolinska Institutet, Stockholm, SwedenDept of Rheumatology and Inflammation Research, Sahlgrenska Academy, Univ. of Gothenburg, Gothenburg, SwedenClinical Epidemiology Division, Dept of Medicine, Karolinska Institutet, Stockholm, SwedenClinical Epidemiology Division, Dept of Medicine, Karolinska Institutet, Stockholm, SwedenObjective To compare work loss after starting tumour necrosis factor inhibitors (TNFi), rituximab, abatacept or tocilizumab in patients with rheumatoid arthritis (RA).Methods We used data from the Swedish Rheumatology Quality Register to identify patients aged 19-62 years who were treated with TNFi (n=15 093), rituximab (n=2123), abatacept (n=1877) or tocilizumab (n=1720) between 2007 and 2020. Data on work loss (0–365 days per year) from sick leave and disability pension were retrieved from linkage to the Social Insurance Agency. Patients in the different treatment arms were balanced regarding baseline covariates using inverse probability weighting (IPTW).Results Work loss increased for patients with RA until drug treatment initiation, reached a peak in the month after treatment initiation and then levelled off. Following IPTW, at 3 years before starting the treatment, there were no statistically significant differences in the mean annual adjusted work loss days between rituximab, abatacept or tocilizumab vs TNFi (mean difference vs TNFi: rituximab 1.1 days, 95% CI −4.5 to 6.7; abatacept 3.3, 95% CI −2.6 to 9.2; tocilizumab 1.2, 95% CI −4.9 to 7.3). At 3 years after starting the treatment (latest January 2021), there were also no statistically significant differences in the mean annual adjusted work loss days (mean difference: rituximab −4.8 days, 95% CI −11.3 to 1.7; abatacept 5.3, 95% CI −1.8 to 12.3; tocilizumab −0.6, 95% CI −7.7 to 6.5).Conclusions Taking channelling into account, patients with RA treated with TNFi, rituximab, abatacept or tocilizumab had similar trajectories of work loss from sick leave and disability pension until treatment initiation, and similar trend breaks and plateau 3 years thereafter.https://rmdopen.bmj.com/content/11/1/e004936.full |
| spellingShingle | Ulf Lindström Johan Askling Katerina Chatzidionysiou Lotta Ljung Lars Klareskog Martin Neovius Nils Feltelius Eva Baecklund Christopher Sjöwall Helena Forsblad-d’Elia Carl Turesson Elisabet Lindqvist Thomas Frisell Alf Kastbom Helena Forsblad-d'Elia Jonas Söderling Ann Knight Gerd-Marie Alenius Gustaf Magnus Bruze Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison RMD Open |
| title | Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison |
| title_full | Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison |
| title_fullStr | Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison |
| title_full_unstemmed | Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison |
| title_short | Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison |
| title_sort | work loss in patients with rheumatoid arthritis treated with abatacept rituximab tocilizumab or tnf inhibitors a nationwide direct drug to drug comparison |
| url | https://rmdopen.bmj.com/content/11/1/e004936.full |
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