Capacity to work is impacted by psoriatic arthritis (PsA). Our objective was to describe the course of work productivity and leisure activity in patients with PsA treated with biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs). A systematic literature review identified all trials and observational studies published January 1, 2010–October 22, 2021, reporting work productivity using the Work Productivity and Activity Impairment Questionnaire (WPAI) in patients with PsA treated with b/tsDMARDs. Outcomes for WPAI domains (absenteeism, presenteeism, total work productivity, and activity impairment) were collected at baseline and time point closest to 24 weeks of treatment. A random effects meta-analysis of single means was conducted to calculate an overall absolute mean change from baseline for each WPAI domain. Twelve studies (ten randomized controlled and two observational) assessing patients treated with adalimumab, bimekizumab, guselkumab, ixekizumab, risankizumab, secukinumab, or upadacitinib were analysed. Among 3741 employed patients, overall mean baseline scores were 11.4%, 38.7%, 42.7%, and 48.9% for absenteeism, presenteeism, total work productivity impairment, and activity impairment, respectively. Estimated absolute mean improvements (95% confidence interval) to week 24 were 2.4 percentage points (%p) (0.6, 4.1), 17.8%p (16.2,19.3), 17.6%p (15.9,19.4), and 19.3%p (17.6, 21.0) respectively, leading to a mean relative improvement of 41% for total work productivity. The change in work outcomes in the b/tsDMARDs appeared similar. This systematic literature review and meta-analysis confirmed that patients with active PsA have a substantially reduced capacity to work and participate in leisure activities. Substantial improvements across various WPAI domains were noted after 24 weeks of b/tsDMARD treatment, especially in presenteeism, total work productivity, and activity impairment. These findings may be useful for reimbursement purposes and in the context of shared decision-making. This systematic literature review (SLR) of randomized clinical trials and observational studies of biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs b/tsDMARDs in patients with PsA found that at treatment introduction, patients presented with a 42.7% mean productivity loss per week as assessed by the Work Productivity and Activity Impairment (WPAI) Questionnaire. Through a meta-analysis comparing before/after values without adjustment for placebo response, we found that after 24 weeks of treatment with b/tsDMARDs, there was a mean absolute improvement of 17.6 percentage points and a mean relative improvement of 41% in total work productivity, with similar magnitudes of improvement in time spent at work and regular activities outside of work. These results provide clinical-, regulatory- and reimbursement decision-makers with data on the potential societal and socio-economic benefits of b/tsDMARDs in PsA. Psoriatic arthritis (PsA) has a major impact on patients’ lives, including their ability to work by causing absence and reducing productivity. By pooling together published studies (12 studies, corresponding to 3741 patients) and comparing what patients reported before starting treatment to during treatment, we found that over the course of treatment with biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs), patients with PsA had an average of 18% higher total work productivity, translating to a 41% reduced impact of PsA at the group level (without looking at comparisons to a placebo response). It is important for health professionals and patients to know that work outcomes affected by PsA are improved when patients take b/tsDMARDS.

中文翻译：

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使用生物或靶向合成药物治疗的银屑病关节炎患者工作效率的提高：系统文献综述和荟萃分析

工作能力受到银屑病关节炎 (PsA) 的影响。我们的目标是描述接受生物制剂 (b) 和靶向合成 (ts) 疾病缓解抗风湿药物 (DMARD) 治疗的 PsA 患者的工作效率和休闲活动过程。系统性文献综述确定了 2010 年 1 月 1 日至 2021 年 10 月 22 日发表的所有试验和观察性研究，使用工作生产力和活动障碍问卷 (WPAI) 报告接受 b/tsDMARD 治疗的 PsA 患者的工作生产力。在基线和最接近治疗 24 周的时间点收集 WPAI 领域的结果（缺勤、出勤、总体工作生产力和活动障碍）。对单一平均值进行随机效应荟萃分析，以计算每个 WPAI 域相对于基线的总体绝对平均变化。分析了 12 项研究（10 项随机对照研究和 2 项观察性研究），评估使用阿达木单抗、bimekizumab、guselkumab、ixekizumab、risankizumab、苏金单抗或 upadacitinib 治疗的患者。在 3741 名就业患者中，缺勤、缺勤、总工作生产力受损和活动受损的总体平均基线评分分别为 11.4%、38.7%、42.7% 和 48.9%。到第 24 周的估计绝对平均改善（95% 置信区间）分别为 2.4 个百分点 (%p) (0.6, 4.1)、17.8%p (16.2,19.3)、17.6%p (15.9,19.4) 和 19.3%p (分别为 17.6、21.0），总体工作生产率平均相对提高 41%。 b/tsDMARD 中工作结果的变化似乎相似。这项系统的文献综述和荟萃分析证实，活动性银屑病关节炎患者的工作和参与休闲活动的能力大大降低。经过 24 周的 b/tsDMARD 治疗后，各个 WPAI 领域均出现了显着改善，特别是在出勤率、总体工作生产力和活动障碍方面。这些发现可能有助于报销目的和共同决策。这项系统文献综述 (SLR) 对生物制剂 (b) 和靶向合成 (ts) 疾病缓解抗风湿药物 b/tsDMARD 在 PsA 患者中的随机临床试验和观察性研究进行了系统性文献综述 (SLR)，结果发现，在引入治疗时，患者的平均缓解率为 42.7%通过工作生产力和活动损害 (WPAI) 调查问卷评估每周的生产力损失。通过比较未调整安慰剂反应的前后值的荟萃分析，我们发现使用 b/tsDMARD 治疗 24 周后，总工作量平均绝对改善了 17.6 个百分点，平均相对改善了 41%生产力，工作时间和工作之外的常规活动的时间也有类似程度的改善。这些结果提供了临床、向监管和报销决策者提供有关 b/tsDMARD 在 PSA 中的潜在社会和社会经济效益的数据。银屑病关节炎 (PsA) 对患者的生活产生重大影响，包括导致缺勤和降低生产力，影响他们的工作能力。通过汇总已发表的研究（12 项研究，对应 3741 名患者）并比较患者在开始治疗前和治疗期间的报告，我们发现在使用生物制剂 (b) 和靶向合成 (ts) 疾病缓解抗风湿药物治疗过程中， （DMARD）显示，PsA 患者的总工作效率平均提高了 18%，这意味着 PsA 对群体的影响降低了 41%（不考虑与安慰剂反应的比较）。对于卫生专业人员和患者来说，重要的是要知道，当患者服用 b/tsDMARDS 时，受 PsA 影响的工作结果会得到改善。