title: Influence of biologic therapy on return to work in people with work disability due to ankylosing spondylitis.
abstract: OBJECTIVE
  To answer the question 'does TNF blockade therapy enable people with severe AS to return to work or work more productively?'.
  
  
  METHODS
  All patients with AS currently receiving anti-TNF therapy at two UK Hospitals were asked to complete a questionnaire. This asked about occupational history, type of work, degree of job-related physical activity, working hours and sickness absence from work both currently (on anti-TNF treatment) and pre-treatment.
  
  
  RESULTS
  Sixty-five patients (72.3% male), aged 29-64 (mean 46.1) yrs, whose duration of anti-TNF treatment ranged from 3 to 56 (mean 19.1) months were studied. Twenty-four (36.9%) patients were receiving infliximab, 21 (32.3%) etanercept and 20 (30.8%) adalimumab. Pre-treatment, 46 (70.8%) were in employment (1 was a student); 38 (58.5%) were working full-time and 8 (12.3%) part-time; 19 (29.2%) were not working. On treatment, 50 (76.9%) patients were working, 44 (67.7%) full-time and 6 (9.2%) part-time. Two individuals who worked part-time pre-treatment had returned to work full-time. Thus, on treatment, 4 of the 19 patients who were previously unable to work returned to employment, and 2 others increased their work from part-time to full-time. Patients rated the effect of AS on work capacity as 7.05/10 pre-treatment and 2.92/10 post-treatment. Those who were working lost, on average, 15 days from work due to sick leave in the 12 months pre-treatment and 0.91 days in the first 12 months on treatment.
  
  
  CONCLUSIONS
  Treatment of active AS with TNF blockade appears to be associated with improved capacity for work.
authors.affiliation: Arthritis Centre, Northwick Park hospital, Harrow, Middlesex HA1 3UJ, UK. andrew.keat@nwlh.nhs.uk
authors.forename: A C
authors.initials: AC
authors.lastname: Keat
authors.forename: K
authors.initials: K
authors.lastname: Gaffney
authors.forename: A K
authors.initials: AK
authors.lastname: Gilbert
authors.forename: C
authors.initials: C
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Leeder
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D004341:Drug Evaluation; D004651:Employment; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000534:rehabilitation*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014938:Work Capacity Evaluation
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept