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Work Loss Not Tied to Drug Choice in Rheumatoid Arthritis

WEDNESDAY, July 3 (HealthDay News) -- Therapy including a biological agent is not superior to conventional therapy in reducing work loss in patients with early-stage rheumatoid arthritis (RA) who fail to respond to methotrexate, according to research published online July 1 in JAMA Internal Medicine.

Jonas K. Eriksson, of the Karolinska Institutet in Stockholm, and colleagues conducted a multicenter trial in which patients, younger than 63 years, with early-stage RA who did not respond to three to four months of methotrexate monotherapy were randomly assigned to receive the addition of either infliximab, a biological agent, or conventional combination therapy with sulfasalazine and hydroxychloroquine. Data on monthly sick leave and disability pension days were analyzed to assess work loss after a 21-month treatment period.

The researchers found that the baseline work loss in both groups averaged 17 days per month. At 21 months, the mean changes in work loss according to intention-to-treat analysis were −4.9 days per month in the group receiving biological therapy and −6.2 days per month in the group receiving conventional therapy, for an adjusted mean difference of 1.6 days per month. Smaller adjusted mean differences between the groups were observed with modified intention-to-treat analysis (1.5 days per month) and per-protocol analysis (0.3 days per month).

"Although it is true that combinations including biological agents were no more effective in reducing sick or pension benefit days, both treatments reduced the number of days by about a quarter," writes the author of an accompanying editorial. "Treating to a target of low disease progression does reduce the work effects of RA, whatever the treatment strategy."

One study author disclosed financial ties to the pharmaceutical industry.

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