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Infliximab Versus Conventional Combination Treatment and Seven-Year Work Loss in Early Rheumatoid Arthritis : Results of a Randomized Swedish Trial

Eriksson, Jonas K; KARLSSON WALLMAN, JOHAN LU ; Miller, Heather; Petersson, Ingemar F LU ; Ernestam, Sofia; Vivar, Nancy; van Vollenhoven, Ronald F and Neovius, Martin (2016) In Arthritis Care and Research1988-01-01+01:002000-01-01+01:00 68(12). p.1758-1766
Abstract

Objective To compare long-term work loss in methotrexate-refractory early rheumatoid arthritis (RA) randomized to addition of infliximab or conventional combination treatment. Methods Multicentre, two-arm, parallel, randomized, active-controlled, open-label trial. RA patients with <1y symptom duration were recruited from 15 rheumatology clinics in Sweden between 2002-2005. Patients who did not achieve low disease activity after 3-4 months methotrexate therapy were randomized to addition of infliximab or conventional combination treatment with sulfasalazine+hydroxychloroquine. Yearly sick leave and disability pension days over 7 years after randomization were retrieved from nationwide registers kept by the Swedish Social Insurance... (More)

Objective To compare long-term work loss in methotrexate-refractory early rheumatoid arthritis (RA) randomized to addition of infliximab or conventional combination treatment. Methods Multicentre, two-arm, parallel, randomized, active-controlled, open-label trial. RA patients with <1y symptom duration were recruited from 15 rheumatology clinics in Sweden between 2002-2005. Patients who did not achieve low disease activity after 3-4 months methotrexate therapy were randomized to addition of infliximab or conventional combination treatment with sulfasalazine+hydroxychloroquine. Yearly sick leave and disability pension days over 7 years after randomization were retrieved from nationwide registers kept by the Swedish Social Insurance Agency. Results Of 210 working age patients, 109 were randomized to infliximab (mean age=48.4y, 73% women) and 101 to conventional treatment (48.7y, 77%). The year before randomization the mean number of annual work days lost was 127 in the infliximab arm and 118 in the conventional treatment group (mean difference, 9; 95%CI, -23 to 39). Compared to the year before randomization, the mean changes at 7 years were -25 days in the infliximab and -26 days in the conventional treatment group (adjusted mean difference, 10; 95%CI, -25 to 46). The mean cumulative work loss days was 846 in the infliximab group and 701 in the conventional treatment group (adjusted mean difference, 104; 95%CI, -56 to 284). Conclusions Long-term work loss improved significantly in early RA randomized to infliximab+methotrexate or conventional combination therapy. No difference was detected between strategies, and the level of work loss days remained twice that observed in the general population.

TRIAL REGISTRATION NUMBER: NCT00764725 This article is protected by copyright. All rights reserved.

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publication status
published
subject
in
Arthritis Care and Research1988-01-01+01:002000-01-01+01:00
volume
68
issue
12
pages
1758 - 1766
publisher
John Wiley & Sons
external identifiers
  • scopus:84997079093
  • wos:000393027400003
ISSN
2151-4658
DOI
10.1002/acr.22899
language
English
LU publication?
yes
id
a8338933-f4c4-4a53-a8e4-f69ed1e19339
date added to LUP
2016-04-15 15:18:25
date last changed
2017-09-24 04:56:11
@article{a8338933-f4c4-4a53-a8e4-f69ed1e19339,
  abstract     = {<p>Objective To compare long-term work loss in methotrexate-refractory early rheumatoid arthritis (RA) randomized to addition of infliximab or conventional combination treatment. Methods Multicentre, two-arm, parallel, randomized, active-controlled, open-label trial. RA patients with &lt;1y symptom duration were recruited from 15 rheumatology clinics in Sweden between 2002-2005. Patients who did not achieve low disease activity after 3-4 months methotrexate therapy were randomized to addition of infliximab or conventional combination treatment with sulfasalazine+hydroxychloroquine. Yearly sick leave and disability pension days over 7 years after randomization were retrieved from nationwide registers kept by the Swedish Social Insurance Agency. Results Of 210 working age patients, 109 were randomized to infliximab (mean age=48.4y, 73% women) and 101 to conventional treatment (48.7y, 77%). The year before randomization the mean number of annual work days lost was 127 in the infliximab arm and 118 in the conventional treatment group (mean difference, 9; 95%CI, -23 to 39). Compared to the year before randomization, the mean changes at 7 years were -25 days in the infliximab and -26 days in the conventional treatment group (adjusted mean difference, 10; 95%CI, -25 to 46). The mean cumulative work loss days was 846 in the infliximab group and 701 in the conventional treatment group (adjusted mean difference, 104; 95%CI, -56 to 284). Conclusions Long-term work loss improved significantly in early RA randomized to infliximab+methotrexate or conventional combination therapy. No difference was detected between strategies, and the level of work loss days remained twice that observed in the general population.</p><p>TRIAL REGISTRATION NUMBER: NCT00764725 This article is protected by copyright. All rights reserved.</p>},
  author       = {Eriksson, Jonas K and KARLSSON WALLMAN, JOHAN and Miller, Heather and Petersson, Ingemar F and Ernestam, Sofia and Vivar, Nancy and van Vollenhoven, Ronald F and Neovius, Martin},
  issn         = {2151-4658},
  language     = {eng},
  month        = {03},
  number       = {12},
  pages        = {1758--1766},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis Care and Research1988-01-01+01:002000-01-01+01:00},
  title        = {Infliximab Versus Conventional Combination Treatment and Seven-Year Work Loss in Early Rheumatoid Arthritis : Results of a Randomized Swedish Trial},
  url          = {http://dx.doi.org/10.1002/acr.22899},
  volume       = {68},
  year         = {2016},
}