Patients receiving Enbrel (etanercept) in combination with methotrexate for early RA are more likely to continue working, according to the COMET study published in Rheumatology.
One year results from the COMET study - which compared the impact of methotrexate alone with methotrexate in combination with Enbrel on work productivity - showed that active early RA patients receiving the Enbrel-methotrexate combination were nearly three times less likely to stop working compared to patients receiving methotrexate alone. Furthermore, work absenteeism was reduced by almost 50 per cent in the combination group.
RA is a chronic and progressive disease that affects 2.9 million people across Europe. As the disease progresses, RA can cause permanent damage to the joints, resulting in deformity and loss of independence.
The prevention of work productivity loss represents benefit beyond the traditional measures of disease improvement. The economic impact of RA is significant, with an estimated €45 billion spent on the disease in Europe each year. Of this, 32 per cent of the total cost is likely due to work disability and decrease in work productivity. Results from previous studies suggest that even in the early stages of disease, RA can impact a person's ability to work.1 In the COMET study, half of the work stoppages observed occurred in the first three months of the trial.1
"Keeping a person gainfully employed represents a benefit to society, above and beyond, the clinical benefits of treatment" said Professor Aslam Anis, School of Population and Public Health, University of British Columbia and lead author of the paper. "The fact that half of the work stoppages occurred in the first three months of this trial, together with the fact that there were significantly fewer work stoppages in the Enbrel-methotrexate combination group, underscore the importance of early and aggressive treatment of RA."
During the COMET (COmbination of Methotrexate and ETanercept) study, work absenteeism was recorded over 12 months amongst 205 patients with early active RA. Total absenteeism was defined as a composite of number of missed workdays, reduced working time and number of days patients were unemployed as a result of their RA.
Previously published data from the COMET trial showed that early treatment of RA can halt the joint damage seen as the disease progresses - 80 per cent of patients in the combination group experienced no further joint damage as measured by x-rays. Furthermore, 50 per cent of patients experienced a sustained reduction in disease activity as measured by the number of swollen joints (i.e. clinical remission) and 55 per cent achieved normal physical functioning, as measured by the Health Assessment Questionnaire.