title: Effect of infliximab therapy on employment, time lost from work, and productivity in patients with psoriatic arthritis.
abstract: OBJECTIVE
  To examine the effect of infliximab on employment status, time lost from work, and productivity in a double-blind, placebo-controlled study of patients with active psoriatic arthritis (PsA).
  
  
  METHODS
  Two hundred adult patients with PsA were randomized to intravenous infusions of either infliximab 5 mg/kg or placebo at Weeks 0, 2, 6, 14, and 22, with early escape at Week 16. Employment status, workdays missed, and productivity were assessed at baseline and at Week 14. The effect of PsA on daily productivity was assessed using a visual analog scale.
  
  
  RESULTS
  At baseline, similar percentages of patients in both treatment groups were employed and similar percentages missed workdays; the mean productivity score at baseline was similar between groups (roughly 3 on a scale of 0 to 10). At Week 14, median productivity increased significantly in the infliximab group compared with the placebo group (67.5% vs 9.2%; p < 0.0001). Compared with the placebo group, higher proportions of patients in the infliximab group improved employment status from unemployed at baseline to employed at Week 14 (11.5% vs 0%; p = 0.084) and from part-time to full-time employment (30.0% vs 10.0%; p = 0.582). Among patients employed at baseline and Week 14, a lower proportion of patients in the infliximab group than in the placebo group had missed workdays in the 4 weeks prior to Week 14 (p = 0.138).
  
  
  CONCLUSIONS
  After 14 weeks of treatment, infliximab improved productivity in patients with active PsA. There was also a trend toward increased employment and reduced time lost from work for patients treated with infliximab.
authors.affiliation: Division of Rheumatology, Allergy and Immunology, University of California at San Diego, 9500 Gilman Drive, San Diego, CA 92093, USA. akavanaugh@ucsd.edu
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.forename: Christian
authors.initials: C
authors.lastname: Antoni
authors.forename: Philip
authors.initials: P
authors.lastname: Mease
authors.forename: Dafna
authors.initials: D
authors.lastname: Gladman
authors.forename: Songkai
authors.initials: S
authors.lastname: Yan
authors.forename: Mohan
authors.initials: M
authors.lastname: Bala
authors.forename: Bei
authors.initials: B
authors.lastname: Zhou
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Dooley
authors.forename: Anna
authors.initials: A
authors.lastname: Beutler
authors.forename: Cynthia
authors.initials: C
authors.lastname: Guzzo
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D004526:Efficiency / Q000187:drug effects*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D018582:Sick Leave; D014478:Unemployment
chemical_list: D000911:Antibodies, Monoclonal; D007155:Immunologic Factors; D000069285:Infliximab