Title: Economic Burden of Axial Spondyloarthritis Related to Paid Work and Household Productivity at Baseline in the Rapid-axSpA Study: Differences and Similarities Between Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis
Abstract: To estimate the economic burden of axial spondyloarthritis (axSpA) and directly compare ankylosing spondylitis (AS) and axSpA with no definitive sacroiliitis on X-ray (non-radiographic axSpA, nr-axSpA) in terms of workplace and household productivity losses. The ongoing Phase 3 RAPID-axSpA trial (NCT01087762) recruited patients (pts) with adult-onset active axSpA according to ASAS criteria, and included AS and nr-axSpA pts. The impact of axSpA on workplace and household productivity was assessed at study baseline (BL), using the arthritis-specific Work Productivity Survey (WPS). At BL, 69.2% of axSpA, 67.4% AS and 71.4% nr-axSpA pts were employed outside the home. A high burden of axSpA on workplace and household productivity and on social activities was reported, with slightly higher burden in nr-axSpA vs AS pts. More AS vs nr-axSpA pts were unable to work (15.7% vs 8.2%). On average, axSpA pts reported >1 wk of paid work and >2 wks of household duties or social activities affected/month. Household productivity losses were up to 2–3 times higher in non-employed and disease work disabled vs employed pts. Employed pts with manual jobs reported higher losses at paid work and within household vs pts with non-manual jobs. 39.1% of axSpA pts required regular assistance in their usual activities (42.1% in AS vs. 35.4% in nr-axSpA) and reported higher workplace and household productivity losses vs those who did not require help. Similar patterns were observed in AS and nr-axSpA. A similarly high burden of disease on workplace and household productivity was seen in AS and nr-axSpA pts that could lead to large financial burden for pts and society. Effective axSpA treatments are needed to prevent disability and work losses and to reduce the economic burden of axSpA.