TNF blockers may enable some rheumatoid arthritis patients to keep working

Last Updated: 2007-11-07 17:56:50 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Results of a new study provide some evidence that use of a tumor necrosis factor (TNF)-alpha blocker may protect against premature work loss in rheumatoid arthritis (RA) patients with relatively short disease duration.

Dr. Saralynn Allaire from Boston University School of Medicine reported the finding at the annual meeting of the American College of Rheumatology underway in Boston.

Anti-TNF-alpha agents are effective in reducing symptoms of RA and also in improving functional limitation, Dr. Allaire noted in a telephone interview with Reuters Health. "Because these agents are really expensive there is a lot of interest in seeing if they actually help people to maintain their employment, which would offset some of the cost of the treatment," she added.

Dr. Allaire and colleagues looked at the impact of anti-TNF-alpha agents on premature work loss in a nested case-control study within a single US cohort of RA patients. A total of 953 patients with RA for a mean of 14 years completed consecutive biannual surveys over 2 years between 2002 and 2005 and were employed and younger than 64 yeas the time of the first survey. Forty-eight percent of these patients reported use of an anti-TNF-alpha agent.

According to the researchers, 231 RA patients were not working at the 2nd and 4th surveys, whereas all 722 matched control patients were employed at all surveys.

In initial analyses, anti-TNF-alpha use did not predict work cessation. However, Dr. Allaire told Reuters Health, "We’ve been doing some further analyses and it looks like among people with shorter disease duration that use of these agents may enable people to continuing working."

In this study, she explained, "shorter (disease duration) was actually fairly long, just under 11 years. Still, the effects of RA are more likely to be malleable in those with relatively short versus very long disease duration."

"This is encouraging," Dr. Allaire said, "and it is something that you’d expect because these agents are known to work most effectively in the early disease period."

"Another interesting piece of research," she noted, "has shown that when patients are treated very early and in those patients who do have a very good response to anti-TNF agents that they do maintain employment and avoid work disability."

Nonetheless, the finding that anti-TNF-alpha agents may protect against premature work stoppage "has to be reported with a bit of caution," Dr. Allaire said, noting that "perhaps that only exists, for example, in a younger person who is working in a job that is not physically demanding."