POS0983 WORK PARTICIPATION IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS IN GERMANY: RESULTS FROM A MULTICENTER, OBSERVATIONAL SURVEY (ATTENTUS-axSpA)
Authors: U. Kiltz, K. Hoeper, L. Hammel, S. Lieb, A. Haehle, D. Meyer-Olson
Journal: Annals of the Rheumatic Diseases (2021)

Background: Axial spondyloarthritis (axSpA) is a chronic inflammatory condition often associated with impaired working participation 1 not only translating to devastating outcomes for patients (pts) but also increased economic and social burden due to a significant amount of indirect costs. Data on the different work participation domains in axSpA pts with access to biologic therapies are limited. Objectives: To characterise the different domains of work participation [presenteeism, absenteeism, sick leave, unemployment, disability pensions] in axSpA pts and their associations with demographic and clinical confounders. Methods: Pts with confirmed clinical diagnosis of axSpA were enrolled in a multicenter, observational ATTENTUS survey conducted across Germany (Nov-2019 to Jul-2020). To ensure high data quality, inclusion criteria was verified by external monitoring, followed by evaluation of the domains of impaired work participation, including absenteeism and presenteeism (WPAI). Demographics, clinical parameters and patient related outcomes (PROs) were collected via tablet. This analysis included working age (18–65 years) pts; and excluded students and retired pts. Pts without absenteeism (value=0) and presenteeism ≤20% were defined as no impairment at work. Results: A total of 787 axSpA pts were enrolled in the survey. Seven students, 68 retired pts and 17 pts not fulfilling the inclusion criteria were excluded from this analysis, leaving 695 pts with complete data sets. Baseline data are outlined in Table 1. 50 pts received disability pensions, 29 pts received unemployment benefits, 590 (84.9%) pts reported paid work [part-time: n=132 (22.4%); full-time: n=458 (65.9%)], with 242 (41.0%) pts having no impairments at work. 379 (64.2%) employed pts took sick leave within the previous 12 months (mo) (&lt;3 mo: n=351; 3–6 mo: n=17; &gt;6 mo: n=11). Absenteeism and presenteeism occurred in 140 (23.7%) and 496 (84.1%) pts, respectively. Pts without impairments were mostly of young age, male sex, well-educated, with low disease activity, less fatigue and shorter duration of morning stiffness, and preserved global and physical functioning. No apparent differences between pts with and without impairment of work participation were observed in terms of biologic treatment, disease duration and BMI. Table 1. Descriptive characteristics of the study population Mean (SD), unless specified Impaired WP (n=453 ) Full WP (n=242 ) p-value Total (n=695 ) Age (yrs) 46.7 (11.1) 42.8 (10.1) &lt;0.001 45.3 (10.9) BMI 28.5 (14.0) 27.0 (6.8) 0.146 28.0 (12.0) Male, n(%) 246 (54) 177 (73) &lt;0.001 423 (61) Disease duration (yrs) 12.7 (11.3) 12.4 (10.2) 0.813 12.6 (11.0) University-Education, n(%) 104 (23.0) 82 (33.9) 0.001 186 (26.8) In a committed relation, n(%) 310 (68.4) 159 (65.7) 0.464 469 (6.6) ASAS-HI 8.0 (3.3) 3.7 (3.0) &lt;0.001 6.5 (3.8) BASDAI 4.8 (1.9) 2.1 (1.6) &lt;0.001 3.9 (2.2) BASDAI &gt; 4, n(%) 286 (63.1) 28 (11.6) &lt;0.001 314 (45.2) Fatigue [BASDAI #1] 5.8 (2.1) 2.8 (2.1) &lt;0.001 4.7 (2.5) Duration morning stiffness [BASDAI #6] 3.5 (2.4) 1.6 (1.8) &lt;0.001 2.8 (2.4) BASFI 4.2 (2.3) 1.5 (1.5) &lt;0.001 3.3 (2.4) Biologic treatment, n(%) 230 (50.8) 134 (55.4) 0.390 364 (52.4) Full time employment, n(%) 256 (56.5) 202 (83.5) &lt;0.001 458 (65.9) Absenteeism 17.9 (32.1) 0 - 10.6 (26.2) Presenteeism 48.6 (21.00) 9.6 (8.3) - 32.6 (25.6) ASAS-HI, Assessment of SpondyloArthritis International Society-Health Index; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BMI, basal metabolic index; n, number of pts; SD, standard deviation; WP, work productivity; years, yrs Conclusion: There was a substantial impact on work participation for axSpA pts, despite numerous available therapeutic options. Pts with impaired work participation compared to pts with no impairment, reported increased fatigue, longer duration of morning stiffness, decreased functional capacity, female sex and a lower level of education. References: [1]Ramoda R et al. Arthritis Res Ther . 2016;78 Disclosure of Interests: Uta Kiltz Speakers bureau: AbbVie, Biocad, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: AbbVie, Biocad, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Grant/research support from: Abbvie, Amgen, Biogen, Fresenius, GSK, Novartis and Pfizer, Kirsten Hoeper Speakers bureau: Abbvie, Chugai, Gilead, Lilly, Novartis, Sandoz Hexal and Sanofi. Consultant of: Abbvie, Chugai, Gilead, Lilly, Novartis, Sandoz Hexal and Sanofi. Ludwig Hammel: None declared, Sebastian Lieb Employee of: Employee of Novartis, Andreas Haehle Employee of: Employee of Novartis, Dirk Meyer-Olson Speakers bureau: Abbvie, Amgen, Berlin Chemie, Bristol Myers Squibb, Cellgene, Chugai, Fresenius Kabi, GSK, Jansen Cilag, Lilly, Medac, Merck Sharp &amp; Dome, Mylan, Novartis, Pfizer, Sandoz Hexal, Sanofi and UCB, Consultant of: Abbvie, Amgen, Berlin Chemie, Bristol Myers Squibb, Cellgene, Chugai, Fresenius Kabi, GSK, Jansen Cilag, Lilly, Medac, Merck Sharp &amp; Dome, Mylan, Novartis, Pfizer, Sandoz Hexal, Sanofi and UCB.