Rheumatoid Arthritis (RA) Patients Taking Enbrel Keep Working for Longer
Study published in Rheumatology underscores the need for early and aggressive treatment to maintain work productivity
Wyeth Europa, Maidenhead, UK. 7 September: Patients receiving Enbrel® (etanercept) in combination with methotrexate for early RA are more likely to continue working, according to the COMET study published today 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.1
RA is a chronic and progressive disease that affects 2.9 million people across Europe.2 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 ?? 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.2 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.
At the end of one year:1 o The number of missed workdays in the group receiving combination treatment of Enbrel and methotrexate (14.2 days) was approximately half that of patients receiving methotrexate monotherapy (31.9 days) o In total, the Enbrel combination group missed up to 37 fewer total days due to absenteeism than the methotrexate monotherapy group o 24 per cent of patients in the monotherapy group had to stop work at least once during the year, compared to 8.6 per cent of patients in the combination therapy group
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.3
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Notes to Editors:
About COMET The COMET (COmbination of Methotrexate and ETanercept in early rheumatoid arthritis) study was designed to compare the clinical efficacy and safety of Enbrel (ETN) and methotrexate (MTX) combination therapy with MTX alone on clinical disease activity and progressive joint damage in patients with active early rheumatoid arthritis. The work analysis was designed to compare the impact of ETN+MTX to MTX alone on work productivity among MTX-naïve patients with active early RA over 12 months.
Two hundred and five patients [MTX (n=100) VS ETN+MTX (n=1050], who were working full time or part time at the start of the trial and had at least one follow-up observation, were included in the analysis. Compared with the MTX group, the ETN+MTX group had a maximum of 37 fewer missed workdays or at minimum 22 fewer missed workdays.
About ENBREL ENBREL is a fully human soluble tumour necrosis factor (TNF) receptor antagonist. ENBREL was first approved in 1998 for moderate to rheumatoid arthritis and has since been used in 505,000 patients worldwide across indications.
ENBREL is approved for the following indications:
Rheumatoid arthritis ENBREL in combination with methotrexate is indicated for the treatment of moderate to severe active rheumatoid arthritis in adults when the response to disease-modifying antirheumatic drugs, including methotrexate (unless contraindicated), has been inadequate. ENBREL can be given as monotherapy in case of intolerance to methotrexate or when continued treatment with methotrexate is inappropriate. ENBREL is also indicated in the treatment of severe, active and progressive rheumatoid arthritis in adults not previously treated with methotrexate. ENBREL, alone or in combination with methotrexate, has been shown to reduce the rate of progression of joint damage as measured by X-ray and to improve physical function.
Polyarticular juvenile idiopathic arthritis Treatment of active polyarticular juvenile idiopathic arthritis in children and adolescents aged 4 to 17 years who have had an inadequate response to, or who have proved intolerant of, methotrexate. ENBREL has not been studied in children aged less than 4 years.
Psoriatic arthritis Treatment of active and progressive psoriatic arthritis in adults when the response to previous disease-modifying antirheumatic drug therapy has been inadequate. ENBREL has been shown to improve physical function in patients with psoriatic arthritis, and to reduce the rate of progression of peripheral joint damage as measured by X-ray in patients with polyarticular symmetrical subtypes of the disease.
Ankylosing spondylitis Treatment of adults with severe active ankylosing spondylitis who have had an inadequate response to conventional therapy.
Plaque psoriasis Treatment of adults with moderate to severe plaque psoriasis who failed to respond to, or who have a contraindication to, or are intolerant to other systemic therapy including cyclosporine, methotrexate or PUVA. ENBREL is also licensed in the European Union for treatment of chronic severe plaque psoriasis in children and adolescents from the age of 8 years who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.
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References 1. Anis A et al. The effect of etanercept on work productivity in patients with early active rheumatoid arthritis: results from the COMET study. Rheumatology doi:10.1093/rheumatology/kep239. E-Pub, 18 August 2009 2. Lundkvistet al. The burden of rheumatoid arthritis and access to treatment: health burden and costs. Eur J Health Econ 2008;8 (Suppl.2):S49-60 3. Emery P et al. Comparison of methotrexate monotherapy with a combination of methotrexate and etanercept in active, early, moderate to severe rheumatoid arthritis (COMET): a randomised, double-blind, parallel treatment trial. Lancet. 2008;372:375-382
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Posted: September 2009