Response to tocilizumab and work productivity in patients with rheumatoid arthritis: 2-year follow-up of FIRST ACT-SC study

Abstract

Objectives

We evaluated long-term control of rheumatoid arthritis (RA) in Japanese paid workers (PWs) and house workers (HWs) treated with subcutaneous tocilizumab (TCZ-SC) and explored factors affecting response to TCZ-SC regarding work productivity.

Methods

This study collected data from patients with RA in the TCZ-SC +/− conventional synthetic disease-modifying antirheumatic drugs group. Factors affecting the response to tocilizumab regarding work productivity were explored using logistic regression. Differences in quality-adjusted life years (QALYs) between with/without response were analysed by a linear regression.

Results

Data were analysed for 357/360 patients. Patients with a ≥ 75% improvement in activity impairment (AI) were considered responders. EuroQol-5 Dimension (EQ-5D), six-item Kessler psychological distress scale score (K6), Health Assessment Questionnaire Disability Index (HAQ-DI), and the patient’s disease global health by visual analogue scale were significant contributors to TCZ-SC response based on improvements in AI. Work Functioning Impairment Scale, presenteeism, EQ-5D, K6, and HAQ-DI significantly contributed to the improvement of overall work impairment in PWs. Shorter disease duration also was related to TCZ-SC response based on AI improvements. Responders had significantly larger mean QALYs than non-responders (difference = 0.2614; p < .001).

Conclusions

These real-world clinical data support long-term work productivity control with TCZ-SC for biologic-naïve HWs and PWs with RA.

Keywords:

• Activity impairment
• rheumatoid arthritis
• patient-reported outcome
• tocilizumab
• work productivity

View correction statement:

Correction

Acknowledgments

The authors wish to thank all co-investigators (listed in Supplementary Table S3) for their contributions. The authors would like to thank Keyra Martinez Dunn, MD, of Edanz Medical Writing for providing medical writing services, which were funded by Chugai Pharmaceutical. Support for study management was provided by EPS Corporation. Finally, we would like to thank all the study sites and investigators who participated in the present study.

Authors’ contributions

All authors contributed to the study protocol development. YT, HK, KS, YK, ET, SY, NT, KF, TF, TK, CH, YF, SM, and HK conducted the study. YT, HK, KS, YK, ET, SY, NT, KF, TF, TK, and HK collected the data. YF and TA performed the statistical analysis. YT, HK, HK, and TA contributed to the development of this manuscript. All authors read and approved the final manuscript excluding CH because he is deceased author.

Conflict of interest

Y. Tanaka received research grants, honoraria and/or speaking fees from AbbVie, Asahi Kasei Pharma, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe Pharma, Novartis, Ono Pharmaceutical, Pfizer, Sanofi, Takeda Pharmaceutical, Teijin Pharma, UCB, and YL Biologics. H. Kameda received research grants and/or speaking fees from AbbVie, Asahi Kasei Pharma, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Eli Lilly, GlaxoSmithKline, Janssen, Mitsubishi-Tanabe Pharma, Novartis, and Pfizer. Y. Kaneko received research grants, consulting fees and/or speaking fees from AbbVie, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe Pharma, Pfizer, Sanofi, and UCB. E. Tanaka received consulting fees from AbbVie, Ayumi Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Nippon Kayaku, Pfizer, Takeda Pharmaceutical, and UCB. S. Yasuda received research grants and/or speaking fees from Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, and MSD. N. Tamura received research grants and/or speaking fees from Astellas Pharma, Asahi Kasei Pharma, Ayumi Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Mitsubishi-Tanabe Pharma, and Takeda Pharmaceutical. K. Fujio received research grants, consulting fees, royalties and/or speaking fees from Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi-Sankyo, Eisai, Integrated Development Associates, Janssen, Mitsubishi-Tanabe Pharma, Pfizer, Santen Pharmaceutical, Takeda Pharmaceutical, Taisho Pharma, and UCB. T. Fujii received research grants and/or speaking fees from Abbvie, Astellas, Asahi-kasei, Ayumi, Chugai, Daiichi-Sankyo, Eli Lilly, Eisai, Janssen, Kissei, Mitsubishi-Tanabe, Nippon-Kayaku, Ono, Pfizer, Sanofi, Taisho Toyama, Takeda, and UCB. T. Kojima received research grants and/or speaking fees from Abbvie, Ayumi Pharmaceutical, Astellas Pharma, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe Pharma, Nippon Kayaku, Novartis, Pfizer, Takeda Pharmaceutical and UCB. T. Anzai is an employee of EPS Corporation. C. Hamada received consulting fees from Chugai Pharmaceutical. H. Kohsaka received consulting fees, and/or speaking fees from Ayumi Pharmaceutical, CSL Behring, Japan Blood Products Organization, and Teijin Pharma. The remaining authors have no conflicts of interest to declare.

Additional information

Funding

This work [UMIN000012306] was supported by Chugai Pharmaceutical, which was not involved in the design of the study; collection, analysis, and interpretation of data; or writing the manuscript.