title: Effect of Adalimumab on Work Ability Assessed in Rheumatoid Arthritis Disease Patients in Saudi Arabia (AWARDS).
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is a chronic disabling disease that can jeopardize the ability of affected individuals to participate in paid work. Our objective was to evaluate the effectiveness of a 6-month course of tumor necrosis factor (TNF) antagonist (adalimumab) on work ability, overall health, and fatigue in RA patients.
  
  
  METHODS
  Between October 2012 and February 2014, this prospective, observational study enrolled 63 consecutive patients with established adult RA at outpatient clinics in Makkah, Jeddah, Riyadh and Abha (Saudi Arabia). Patients received subcutaneous injections of adalimumab (40 mg every 2 weeks). Outcomes were measured at baseline and 6 months using the following tools: Work Productivity and Activity Impairment (WPAI), Health Assessment Questionnaire Disability Index (HAQ-DI), Fatigue Severity Scale (FSS), Visual Analog Scale for Fatigue (VAS-F), and work disability self-assessment.
  
  
  RESULTS
  All outcomes showed improvements after 6 months of adalimumab therapy. Significant improvements from baseline were observed in absenteeism (64% ± 11.62 to 11.60% ± 11.17 [p<0.0001]), presenteeism (62.15% ± 20.11 to 34.92% ± 20.61 [p<0.0001]), overall work impairment (69.08% ± 18.86 to 40.73% ± 22.29 [p<0.0001]), overall activity impairment (68.46% ± 18.58 to 36.46% ± 20.79 [p<0.0001]), HAQ score (1.69 ± 0.57 to 0.81 ± 0.61 [p<0.0001]), and FSS score (47.08 ± 9.55 to 27.86 ± 13.43 [p<0.0001]).
  
  
  CONCLUSIONS
  A 6-month course of adalimumab improved work ability, fatigue, and overall health assessments in patients with established RA. Our findings encourage randomized controlled trials investigating the cost-effectiveness and long-term effects of TNF inhibitors on work disability.
authors: Department of Medicine, Heraa General Hospital, Makkah, Saudi Arabia.
authors: Waleed
authors: W
authors: Hussain
authors: Department of Medicine, Dr. Soleiman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors: Nahid
authors: N
authors: Janoudi
authors: Department of Medicine, Umm Alqura University, Makkah, Saudi Arabia ; Department of Medicine, Alnoor General Hospital, Makkah, Saudi Arabia.
authors: Abdulsalam
authors: A
authors: Noorwali
authors: Department of Medicine, Alnoor General Hospital, Makkah, Saudi Arabia.
authors: Narges
authors: N
authors: Omran
authors: Department of Medicine, King Abdulaziz Hospital and Oncology Center, Jeddah, Saudi Arabia.
authors: Matouqa
authors: M
authors: Baamer
authors: Department of Medicine, Aseer Center Hospital, Abha, Saudi Arabia.
authors: El Hussain
authors: el H
authors: Assiry
authors: Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia.
authors: Hanan
authors: H
authors: Alrayes
authors: Alzaidi Chair of Research in Rheumatic Diseases, Medical College, Umm Alqura University, Makkah, Saudi Arabia.
authors: Hanan
authors: H
authors: Alosaimi
authors: Alzaidi Chair of Research in Rheumatic Diseases, Medical College, Umm Alqura University, Makkah, Saudi Arabia.
authors: Ashraf
authors: A
authors: Ibrahim
authors: Alzaidi Chair of Research in Rheumatic Diseases, Medical College, Umm Alqura University, Makkah, Saudi Arabia.
authors: Shereen
authors: S
authors: Gohary
authors: Alzaidi Chair of Research in Rheumatic Diseases, Medical College, Umm Alqura University, Makkah, Saudi Arabia.
authors: Joan
authors: J
authors: Mignuet
authors: Department of Medicine, Dr. Soleiman Fakeeh Hospital, Jeddah, Saudi Arabia ; Department of Medicine, Umm Alqura University, Makkah, Saudi Arabia ; Alzaidi Chair of Research in Rheumatic Diseases, Medical College, Umm Alqura University, Makkah, Saudi Arabia.
authors: Hani
authors: H
authors: Almoallim
keywords: Adalimumab; health assessment; rheumatoid arthritis; tumor necrosis factor (TNF) inhibitor; work ability