Work participation in patients with axial spondyloarthritis Save

Patients with axial spondyloarthritis (axSpA) often have increased absence from work as well as reduced productivity at work, which can have profound impacts for not only the affected individual and their families, but also lead to wider economic and social burden.

It is essential to be able to effectively assess this impact so that we can improve the patient experience of their disease and the wider socioeconomic impacts, including reducing impact on ability to work and subsequent quality of life. 

U. Kiltz et al (#0358) et al sought to characterise the various domains of work participation in patients with axSpA. Work participation can be divided into factors such as sick leave, unemployment, disability pensions, as well as absenteeism (absence from work) and presenteeism (decreased productivity whilst being present at work). Just under 700 patients with axSpA were included in the study, with absenteeism noted in 140 and presenteeism in 496. Individuals with decreased work impairments were noted to be younger, male, higher education attainment, low disease activity, less fatigued, and overall better global functioning. This is despite the availability of an increasing number of therapeutic options available.

One such well-established, therapeutic option is TNF inhibition. M. Rudwaleit et al (#0362) looked into the changes in clinical outcome and burden on work and productivity with the use of certolizumab pegol (CZP). Work participation was measured used the Work Productivity Survey (WPS), a validated tool for assessment in patients with arthritis. Their findings indicated that achievement of good clinical response after four years of treatment was associated with improved household productivity and greater ability to participate in paid work, suggesting better disease control can reduce the impact of axSpA on patients’ quality of life, and social and work burden.

Taking these studies together, it is evident that a combined approach of pharmaceutical and non-pharmaceutical approaches are required to optimise functioning and quality of life in patients with axSpA.

Work participation encompasses much more than the ability to be present at work- productivity, social functioning and requirements for sick leave all contribute to a patient’s experience and ability to work. It therefore follows that improvements in this area require a more holistic and multi-disciplinary approach, in addition to effective therapeutic agents.