Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison
Authors' conclusion
Taking channelling into account, patients with RA treated with TNFi, rituximab, abatacept or tocilizumab had similar trajectories of work loss from sick leave and disability pension until treatment initiation, and similar trend breaks and plateau 3 years thereafter.
Study context
- Population
- Patients with rheumatoid arthritis (RA) aged 19–62 years in the Swedish Rheumatology Quality Register, treated 2007–2020
- Participants
- 15,093 / 2,123 / 1,877 / 1,720
- Exposure
- Rituximab, abatacept or tocilizumab vs tumour necrosis factor inhibitors (TNFi)
- TNFin = 15,093reference
- Rituximabn = 2,123
- Abataceptn = 1,877
- Tocilizumabn = 1,720
- Outcome
- Work loss (0-365 days per year) from sick leave and disability pension
Methodological detailsregister-based, inverse probability weighting (IPTW)
- Register-based
- Inverse probability weighting (IPTW)
Main finding
As reported in the abstract
Mean annual adjusted work loss days, after IPTW · 3 years after starting treatment
Each group vs TNFiMean difference, days (95% CI)
Rituximab
−4.8(−11.3 to 1.7)
Abatacept
5.3(−1.8 to 12.3)
Tocilizumab
−0.6(−7.7 to 6.5)
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (days) (95% CI) | |
|---|---|---|
| Mean annual adjusted work loss days, after IPTW · 3 years before starting treatmentRituximabvs TNFi | 1.1 (−4.5 to 6.7) | |
| Mean annual adjusted work loss days, after IPTW · 3 years before starting treatmentAbataceptvs TNFi | 3.3 (−2.6 to 9.2) | |
| Mean annual adjusted work loss days, after IPTW · 3 years before starting treatmentTocilizumabvs TNFi | 1.2 (−4.9 to 7.3) | |
| −50510Difference, days (linear scale) |
Mean annual adjusted work loss days, after IPTW · 3 years before starting treatment
- No statistically significant differences vs TNFi
Work loss trajectory
- Work loss increased until drug initiation, peaked in the month after initiation and then levelled off
Original publication
Work loss in patients with rheumatoid arthritis treated with abatacept, rituximab, tocilizumab or TNF inhibitors: a nationwide direct drug-to-drug comparison. RMD Open. Published 29 January 2025. doi:10.
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