Neovius M, Simard JF, Klareskog L & Askling J for the ARTIS Study Group

1. Neovius M, Simard JF, Klareskog L & Askling J for the ARTIS Study Group Ann Rheum Dis 2011;70(8):1407-14. PMID: 21518724 Sick leave and disability pension before and after initiation of antirheumatictherapies in clinicalpractice

2. Background • Antirheumatic treatmentAnti-TNF drugs constituted 5% of the total national drug expenditure in Sweden in 2009 (excl OTC-drugs) • Work force participation Productivity losses in the RA population are largeEffects on productivity hold potential for offsetting some of the treatment cost

4. Background Neovius M, Simard JF, Askling J. Howlarge are the productivitylosses in contemporary patients with RA, and howsoon in relation to diagnosisdotheydevelop? Ann Rheum Dis 2011;70(6):1010-15.

5. Objective To assess annual days on sick leave & disability pension before & after antirheumatic treatment initiation in a nationwide RA cohort

6. Methods • Patients • 19-60y old patients with RA initiating treatment in 1999-2007 • Identified in the Swedish Rheumatology Quality Register (SRQ), including the Swedish Biologics Register ARTIS • Treatment cohorts • Mono-DMARD (n=2,796) • Combo-DMARD (n=973) • Biologics (n=4,787) • Outcome • Annual net days on sick leave & disability pension (max 365 days) • From the Swedish Social Insurance Agency (1995 to 2010)

7. Prevalence of RA by Age and Sex(Jan 1, 2008; n=58 102) 45% <65y Neovius, Simard & Askling for the ARTIS Study Group Ann Rheum Dis. 2011

8. Results • By Month • By Year • By Calendar Period

13. 2 Sick leave vs disability pension Meandays by therapy Median days & distribution of days by therapy 2 By Year

17. 2 Neovius M, Simard JF, Klareskog L & Askling J for the ARTIS Study Group, Ann Rheum Dis. 2011

18. 3 By calendar period

20. Conclusion • History of increasing productivity lossesThe patient group selected for therapy was characterized by a history of rapid increases in annual sick leave & disability pension days • Breakpoint but no reversalTreatment was associated with a breakpoint in this pattern, but days off work remained far from the level observed before RA-diagnosis • A large unmet need remainsIntervention appears to be needed earlier in the disease process

21. RelatedArticles from SRQ/ARTIS • Askling J, Fored CM, Geborek P, Jacobsson LT, van Vollenhoven R, Feltelius N, Lindblad S, Klareskog LSwedish registers to examinedrugsafety and clinicalissues in RA Ann Rheum Dis 2006;65(6):707-12. • Neovius M, Simard JF, Askling J for the ARTIS Study Group Howlarge are the productivitylosses in contemporary patients with RA, and howsoon in relation to diagnosisdotheydevelop? Ann Rheum Dis 2011;70(6):1010-15. • Simard JF, Arkema EV, Sundstrom A, Geborek P, Saxne T, Baecklund E, Coster L, Dackhammar C, Jacobsson L, Feltelius N, Lindblad S, Rantapaa-Dahlqvist S, Klareskog L, van Vollenhoven RF, Neovius M, Askling JTen years with biologics: to whomdo data on effectiveness and safetyapply? Rheumatology (Oxford) 2011;50(1):204-13. • Neovius M, Simard JF, Askling J for the ARTIS Study GroupNationwide prevalence of rheumatoidarthritis and penetration of disease-modifyingdrugs in SwedenAnn Rheum Dis 2011;70(4):624-29. • Neovius M, Simard J, Sundstrom A, Jacobsson L, Geborek P, Saxne T, Feltelius N, Klareskog L, Askling J. Generalisability of clinical registers used for drug safety and comparative effectiveness research: coverage of the Swedish Biologics Register. Ann Rheum Dis 2011;70(3):516-19.