Hokkanen Anna-Mari, Aaltonen Kalle, Relas Heikki, Rutanen Jarno, Kononoff Aulikki, Taimen Kirsi, Kauppi Markku, Puolakka Kari, Trokovic Nina, Nordström Dan
ROB-FIN Register, Division of Rheumatology, Helsinki University Hospital, Helsinki, Finland.
Division of Rheumatology, Päijät-Häme Central Hospital, Lahti, Finland.
Rheumatol Adv Pract. 2023 May 25;7(2):rkad050. doi: 10.1093/rap/rkad050. eCollection 2023.
The aim was to investigate the effect of TNF inhibitor (TNFi) initiation on working ability and health-care resource utilization among axial SpA patients in a real-life setting.
Patients with a clinical diagnosis of non-radiographic (nr-axSpA) or radiographic axial SpA initiating their first TNFi were identified from the National Register for Antirheumatic and Biologic Treatment in Finland. Sickness absences, including sick leave and disability pension, in- and outpatient days and rehabilitation rates, 1 year before and after initiating the medication were retrieved from national registries. Factors affecting result variables were studied using multivariate regression analysis.
Overall, 787 patients were identified. Rates of work disability days per year were 55.6 the year before treatment onset and 55.2 the year after, with significant differences between patient subgroups. The rate of sick leave decreased after starting TNFi treatment. However, the rate of disability pension continued to rise. Patients with a diagnosis of nr-axSpA experienced a decrease in overall work disability and, especially, fewer sick leaves. No sex differences were detected.
TNFi interrupts the increase in work disabled days evident during the year before its initiation. However, the overall work disability remains high. Treating patients earlier in the nr-axSpA phase, regardless of sex, appears important in maintaining the ability to work.
旨在调查在现实生活环境中，肿瘤坏死因子抑制剂（TNFi）起始治疗对轴性脊柱关节炎（axial SpA）患者工作能力和医疗资源利用的影响。
从芬兰国家抗风湿和生物治疗登记处识别出首次开始使用TNFi进行临床诊断为非放射学（nr-axSpA）或放射学轴性脊柱关节炎的患者。从国家登记处获取用药前1年和用药后1年的病假情况，包括病假和残疾抚恤金、门诊和住院天数以及康复率。使用多变量回归分析研究影响结果变量的因素。
总共识别出787例患者。治疗开始前每年的工作残疾天数率为55.6天，治疗开始后为55.2天，患者亚组之间存在显著差异。开始TNFi治疗后病假率下降。然而，残疾抚恤金率继续上升。诊断为nr-axSpA的患者总体工作残疾有所减少，尤其是病假天数减少。未检测到性别差异。
TNFi可中断其起始治疗前一年明显增加的工作残疾天数。然而，总体工作残疾率仍然很高。在nr-axSpA阶段尽早治疗患者，无论性别如何，对于维持工作能力似乎都很重要。
