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Rheumatology Advance Access published online on February 16, 2008
Rheumatology, doi:10.1093/rheumatology/ken010
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Influence of biologic therapy on return to work in people with work disability due to ankylosing spondylitis

A. C. Keat1, K. Gaffney2, A. K. Gilbert1, C. Harris1 and J. Leeder2

1Arthritis Centre, Northwick Park Hospital, Harrow, Middlesex HA1 3UJ and 2Rheumatology Department, Norfolk and Norwich University Hospital, Norwich, Norfolk NR4 7UY, UK.

Correspondence to: A. C. Keat, Arthritis Centre, Northwick Park hospital, Harrow, Middlesex HA1 3UJ, UK. E-mail: andrew.keat{at}nwlh.nhs.uk


  Abstract

Objective. To answer the question ‘does TNF blockade therapy enable people with severe AS to return to work or work more productively?’.

Methods. All patients with AS currently receiving anti-TNF therapy at two UK Hospitals were asked to complete a questionnaire. This asked about occupational history, type of work, degree of job-related physical activity, working hours and sickness absence from work both currently (on anti-TNF treatment) and pre-treatment.

Results. Sixty-five patients (72.3% male), aged 29–64 (mean 46.1) yrs, whose duration of anti-TNF treatment ranged from 3 to 56 (mean 19.1) months were studied. Twenty-four (36.9%) patients were receiving infliximab, 21 (32.3%) etanercept and 20 (30.8%) adalimumab. Pre-treatment, 46 (70.8%) were in employment (1 was a student); 38 (58.5%) were working full-time and 8 (12.3%) part-time; 19 (29.2%) were not working. On treatment, 50 (76.9%) patients were working, 44 (67.7%) full-time and 6 (9.2%) part-time. Two individuals who worked part-time pre-treatment had returned to work full-time. Thus, on treatment, 4 of the 19 patients who were previously unable to work returned to employment, and 2 others increased their work from part-time to full-time. Patients rated the effect of AS on work capacity as 7.05/10 pre-treatment and 2.92/10 post-treatment. Those who were working lost, on average, 15 days from work due to sick leave in the 12 months pre-treatment and 0.91 days in the first 12 months on treatment.

Conclusions. Treatment of active AS with TNF blockade appears to be associated with improved capacity for work.

KEY WORDS: Ankylosing spondylitis, Biologic therapy, Anti-TNF, Work, Socioeconomic, Employment, Work disability

Submitted 1 October 2007; revised version accepted 4 January 2008.
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