The effects of adalimumab treatment and psoriasis severity on self-reported work productivity and activity impairment for patients with moderate to severe psoriasis.
The effects of adalimumab treatment and psoriasis severity on self-reported work productivity and activity impairment for patients with moderate to severe psoriasis.
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DOI：
10.1016/j.jaad.2010.10.020
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发表时间：
2012-02-01
影响因子：
13.8
通讯作者：
Mulani, Parvez M
中科院分区：
文献类型：
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作者：
Kimball, Alexa Boer;Yu, Andrew P;Mulani, Parvez M
背景：银屑病显着损害工作效率和日常活动。 目的：我们旨在研究阿达木单抗对银屑病相关工作效率和活动损害的影响，以及中度至重度银屑病患者的损害与银屑病严重程度之间的关联。方法：数据来自阿达木单抗随机对照评估的前 16 周，在中度至重度银屑病试验中每隔一周给药一次 （揭示）。银屑病工作生产力和活动损伤问卷 (WPAI-Psoriasis) 测量的结果包括就业状况、总体工作生产力损伤和总体活动损伤。使用逻辑回归和协方差分析来评估阿达木单抗和治疗反应（银屑病面积和严重性指数反应者改善≥ 75%）对 WPAI-银屑病结果的影响。纵向广义估计方程和 Pearson 相关系数用于评估 WPAI 结果与银屑病严重程度之间的关联。结果：与安慰剂相比，阿达木单抗治疗组在总工作生产力损害和总活动损害方面观察到更大的改善（分别为 15.5 和 11.1 个百分点；P < .001）。失业率、总体工作生产力受损和总体活动受损与基线银屑病严重程度显着相关。 WPAI 结果的变化与银屑病严重程度显着相关。与临床严重程度衡量指标（银屑病面积和严重程度指数以及医师整体评估）相比，皮肤科生活质量指数与 WPAI 结果变化的关联性更强。 局限性：REVEAL 仅包含 16 周的 WPAI 数据。因此，无法评估阿达木单抗治疗对生产力结果的长期影响。此外，没有收集有关职业职称或行业的信息，也没有针对银屑病关节炎调整数据。结论：阿达木单抗降低了中度至重度银屑病患者的银屑病相关工作效率和活动障碍。
BACKGROUND: Psoriasis significantly impairs work productivity and daily activities.OBJECTIVES: We sought to examine the effects of adalimumab on psoriasis-related work productivity and activity impairment and associations between the impairment and psoriasis severity in patients with moderate to severe psoriasis.METHODS: Data were from the first 16 weeks of the Randomized controlled EValuation of adalimumab Every other week dosing in moderate to severe psoriasis TriAL (REVEAL). Outcomes as measured by the Work Productivity and Activity Impairment Questionnaire for Psoriasis (WPAI-Psoriasis) included employment status, total work productivity impairment, and total activity impairment. Logistic regression and analyses of covariance were used to assess the effects of adalimumab and treatment response (≥ 75% improvement in Psoriasis Area and Severity Index responders) on WPAI-Psoriasis outcomes. Longitudinal generalized estimating equations and Pearson correlation coefficients were used to assess associations between WPAI outcomes and psoriasis severity.RESULTS: Greater improvements in total work productivity impairment and total activity impairment were observed with adalimumab treatment versus placebo (15.5 and 11.1 percentage points, respectively; P < .001). Unemployment rate, total work productivity impairment, and total activity impairment were significantly associated with greater baseline psoriasis severity. Changes in WPAI outcomes were significantly correlated with greater psoriasis severity. The Dermatology Life Quality Index had stronger associations with changes in WPAI outcomes compared with clinical severity measures (Psoriasis Area and Severity Index and Physician Global Assessment).LIMITATIONS: REVEAL only included WPAI data for 16 weeks. Therefore, long-term impact of adalimumab treatment on productivity outcomes could not be assessed. In addition, information on occupational job title or industry was not collected and data were not adjusted for psoriatic arthritis.CONCLUSIONS: Adalimumab reduced psoriasis-related work productivity and activity impairment in patients with moderate to severe psoriasis.