PMID- 30029613
OWN - NLM
STAT- In-Process
LR  - 20181230
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Linking)
VI  - 20
IP  - 1
DP  - 2018 Jul 20
TI  - Effect of subcutaneous tocilizumab treatment on work/housework status in
      biologic-naive rheumatoid arthritis patients using inverse probability of
      treatment weighting: FIRST ACT-SC study.
PG  - 151
LID - 10.1186/s13075-018-1647-3 [doi]
AB  - BACKGROUND: Following the onset of rheumatoid arthritis (RA), patients experience
      a functional decline caused by various joint symptoms which affects their
      activities of daily living and can lead to reduced work productivity. We
      evaluated the effect of a 52-week treatment with tocilizumab by subcutaneous
      injection (TCZ-SC) among biologic-naive Japanese house workers (HWs) and paid
      workers (PWs) with RA in a real-world clinical practice. METHODS: This
      multicenter, observational, prospective study enrolled 377 and 347 RA patients
      into TCZ-SC and conventional synthetic disease-modifying antirheumatic drugs
      (csDMARDs)-alone groups, respectively. The primary endpoint was the change in
      percentage of overall work impairment (OWI) among PWs at week 52 assessed using
      the Work Productivity and Activity Impairment Questionnaire (WPAI). Inverse
      probability of treatment weighting analyses were used to compare treatments. The 
      Work Functioning Impairment Scale, disease activity, quality of life (QOL)
      measures, and safety were also assessed. RESULTS: The weighted change in OWI from
      baseline for PWs was -18.9% (TCZ-SC group) and -19.0% (csDMARDs group) at week
      52, without a significant between-group difference (adjusted treatment difference
      0.1, 95% confidence interval (CI) -6.3 to 6.5; P = 0.978). Changes in WPAI
      activity impairment in the overall group (between-group difference -6.4, 95% CI
      -10.7 to -2.2; P = 0.003) and HWs (-9.5, 95% CI - 16.0 to -2.9; P = 0.005) were
      significantly better with TCZ-SC than with csDMARDs at week 52. TCZ-SC-treated
      HWs showed significant improvement in all QOL assessments (Frenchay Activities
      Index, EuroQol 5 Dimension (EQ-5D), Japanese Health Assessment Questionnaire
      Disability Index (HAQ-DI), and 6-item Kessler scale (K6)) at week 52; PWs did not
      show any between-group differences for these QOL measures. Disease activity
      (Disease Activity Score 28-erythrocyte sedimentation rate, Clinical Disease
      Activity Index, and Simplified Disease Activity Index) and QOL measures (EQ-5D,
      HAQ-DI, and K6) improved over time in the overall group. No new safety concerns
      were raised with TCZ-SC. CONCLUSIONS: Despite the lack of differences in OWI
      between groups at week 52, the overall group (particularly HWs) receiving TCZ-SC 
      in addition to csDMARDs showed significant improvements in activity impairment,
      disease activity, and QOL versus those receiving csDMARDs alone. This study may
      promote the evaluation of work productivity improvements in HWs and PWs by RA
      treatment.
FAU - Tanaka, Yoshiya
AU  - Tanaka Y
AD  - University of Occupational and Environmental Health, 1-1 Iseigaoka,
      Yahatanishi-ku, Kitakyushu, Fukuoka, 807-0804, Japan. tanaka@med.uoeh-u.ac.jp.
FAU - Kameda, Hideto
AU  - Kameda H
AD  - Toho University, 2-22-36 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
FAU - Saito, Kazuyoshi
AU  - Saito K
AD  - University of Occupational and Environmental Health, 1-1 Iseigaoka,
      Yahatanishi-ku, Kitakyushu, Fukuoka, 807-0804, Japan.
AD  - Tobata General Hospital, 1-3-33 Fukuryugi, Tobata-ku, Kitakyushu, Fukuoka,
      804-0025, Japan.
FAU - Kaneko, Yuko
AU  - Kaneko Y
AD  - Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo,
      160-8582, Japan.
FAU - Tanaka, Eiichi
AU  - Tanaka E
AD  - Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054,
      Japan.
FAU - Yasuda, Shinsuke
AU  - Yasuda S
AD  - Hokkaido University, N15, W7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
FAU - Tamura, Naoto
AU  - Tamura N
AD  - Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, 
      Japan.
FAU - Fujio, Keishi
AU  - Fujio K
AD  - The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
FAU - Fujii, Takao
AU  - Fujii T
AD  - Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.
FAU - Kojima, Toshihisa
AU  - Kojima T
AD  - Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya,
      Aichi, 466-8550, Japan.
FAU - Anzai, Tatsuhiko
AU  - Anzai T
AD  - EPS Corporation, 6-29 Shinogawamachi, Shinjuku-ku, Tokyo, 162-0814, Japan.
FAU - Hamada, Chikuma
AU  - Hamada C
AD  - Tokyo University of Science, 6-3-1 Niijuku, Katsuhika-ku, Tokyo, 125-8585, Japan.
FAU - Fujino, Yoshihisa
AU  - Fujino Y
AD  - University of Occupational and Environmental Health, 1-1 Iseigaoka,
      Yahatanishi-ku, Kitakyushu, Fukuoka, 807-0804, Japan.
FAU - Matsuda, Shinya
AU  - Matsuda S
AD  - University of Occupational and Environmental Health, 1-1 Iseigaoka,
      Yahatanishi-ku, Kitakyushu, Fukuoka, 807-0804, Japan.
FAU - Kohsaka, Hitoshi
AU  - Kohsaka H
AD  - Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, 
      Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180720
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
PMC - PMC6053758
OTO - NOTNLM
OT  - *Disease activity
OT  - *Quality of life
OT  - *Rheumatoid arthritis
OT  - *Tocilizumab
OT  - *Work disability
EDAT- 2018/07/22 06:00
MHDA- 2018/07/22 06:00
CRDT- 2018/07/22 06:00
PHST- 2018/01/09 00:00 [received]
PHST- 2018/06/18 00:00 [accepted]
PHST- 2018/07/22 06:00 [entrez]
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2018/07/22 06:00 [medline]
AID - 10.1186/s13075-018-1647-3 [doi]
AID - 10.1186/s13075-018-1647-3 [pii]
PST - epublish
SO  - Arthritis Res Ther. 2018 Jul 20;20(1):151. doi: 10.1186/s13075-018-1647-3.