title: Employment is maintained and sick days decreased in psoriasis/psoriatic arthritis patients with etanercept treatment.
abstract: BACKGROUND
  Psoriasis and psoriatic arthritis (PsA) impair quality of life, including reduction in employment or job duties. The PRESTA (Psoriasis Randomized Etanercept STudy in Patients with Psoriatic Arthritis) study, a randomized, double-blind, two-dose trial, examined the efficacy of etanercept treatment in patients with moderate-to-severe plaque psoriasis and PsA and the main results have been presented previously. This analysis examined employment status, job duties and sick days, pre-defined endpoints in PRESTA, among this patient population.
  
  
  METHODS
  Participants (N=752) were randomized to receive etanercept 50 mg twice weekly (BIW; n=379) or 50 mg once weekly (QW; n=373) for 12 weeks by subcutaneous injection. All participants then received open-label etanercept 50 mg QW for 12 additional weeks, while remaining blinded to the randomization. A pharmacoeconomic questionnaire was administered at baseline, week 12 and week 24 of treatment. The questionnaire included employment status and changing job responsibilities and sick time taken due to psoriasis or PsA. The statistical methods included analysis of covariance, t-test, Fisher's exact test and McNemar's test. Last-observation-carried-forward imputation was used for missing data.
  
  
  RESULTS
  Employment was at least maintained from baseline to week 24 in both dose groups (56% [BIW/QW] and 60% [QW/QW] at baseline, 61% and 60%, respectively, at week 24). Among employed participants, the proportion of patients whose job responsibilities changed due to PsA decreased significantly from baseline to week 24 (17-23% to 5-8%; p<0.01). Similar results were seen with job responsibility changes due to psoriasis (11-14% to 4%; p<0.01). The number of monthly sick days also decreased from baseline to week 24 (2.4 days for both treatment groups to 0.7 (BIW/QW) and 1.1 (QW/QW); p≤0.03 for each). No significant differences between the treatment groups were observed for any economic endpoint at any time point.
  
  
  CONCLUSIONS
  For patients with moderate-to-severe plaque psoriasis and PsA, etanercept treatment resulted in reducing job responsibility changes due to disease and in reducing sick time. Effective treatment of psoriasis and PsA may reduce missed work days.
authors.affiliation: Formerly of Pfizer Inc,, 3921 Glenlake Garden Drive, Raleigh, NC 27612, USA. bobboggs.nc@gmail.com.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Boggs
authors.forename: Sarolta
authors.initials: S
authors.lastname: Kárpáti
authors.forename: Wenzhi
authors.initials: W
authors.lastname: Li
authors.forename: Theresa
authors.initials: T
authors.lastname: Williams
authors.forename: Ronald
authors.initials: R
authors.lastname: Pedersen
authors.forename: Lotus
authors.initials: L
authors.lastname: Mallbris
authors.forename: Robert
authors.initials: R
authors.lastname: Gniadecki
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000191:economics; D017281:Cost of Illness; D004311:Double-Blind Method; D004651:Employment; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D018582:Sick Leave; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
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