Abstract
Introduction
Familial Mediterranean fever (FMF) is characterized by recurrent attacks of fever, serositis, and arthritis. Some patients suffer from associated inflammatory conditions and damage related to FMF that may potentially impair work productivity which have not been studied to date.
Methods
Consecutive FMF patients who were attending a tertiary referral center and age-and sex-matched healthy subjects enrolled into the study. Disease activity was assessed with autoinflammatory disease activity index (AIDAI) and patient global assessment. Damage was evaluated using Autoinflammatory Disease Damage Index (ADDI). Quality of life (QoL) and work productivity were determined with 36-Item Short Form Health Survey (SF-36) and Work Productivity and Activity Impairment Specific Health Problem v2.0 (WPAI:SHP), respectively.
Results
There were 111 FMF patients, 60 female (54%), mean age 32.7±8.7 years. There were significant impairments in all domains of the SF-36 QoL in FMF patients. Of the 111 patients enrolled, 65 (58.6%) were employed in a paid work. Mean% ±SD impairment in work productivity both assessed as absenteeism (9.3±23.2% vs. 0.7±2.6, p=0.013) and presenteeism (35.2±32.6% vs. 9.6±14.7, p<0.001) were significantly higher in FMF patients compared to healthy subjects. Impairment in work productivity was correlated with the number of attacks, disease activity, colchicine resistance, and disease-associated damage. Impairment was most significant in colchicine-resistant FMF patients but lower in those on interleukin (IL)-1 antagonist treatments.
Conclusions
FMF causes significant work impairment and reduced QoL which is associated with disease activity and damage. The use of IL-1 antagonists may help to improve work productivity and QoL in FMF patients with frequent attacks.
Key points • Work productivity is impaired in patients with FMF. • Disease activity was an independent predictor for impaired work productivity. • IL-1 antagonists may improve work productivity and quality of life in FMF patients with frequent attacks. |
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References
Babaoglu H, Armagan B, Bodakci E, Satis H, Atas N, Sari A et al (2020) Predictors of persistent inflammation in familial Mediterranean fever and association with damage. Rheumatology (Oxford, England). https://doi.org/10.1093/rheumatology/keaa378
Karadag O, Tufan A, Yazisiz V, Ureten K, Yilmaz S, Cinar M, Akdogan A, Erdem H, Ozturk MA, Pay S, Dinc A (2013) The factors considered as trigger for the attacks in patients with familial Mediterranean fever. Rheumatol Int 33(4):893–897. https://doi.org/10.1007/s00296-012-2453-x
Babaoglu H, Varan O, Atas N, Satis H, Salman R, Ozturk MA, Goker B, Haznedaroglu S, Tufan A (2019) Detection of familial Mediterranean fever attacks by using a connected activity tracker and assessment of impact of attacks to daily physical activities: a pilot study. Clin Rheumatol 38(7):1941–1946. https://doi.org/10.1007/s10067-019-04493-6
Atas N, Armagan B, Bodakci E, Satis H, Sari A, Bilge NSY, Salman RB, Yardımcı GK, Babaoglu H, Guler AA, Karadeniz H, Kilic L, Ozturk MA, Goker B, Haznedaroglu S, Kalyoncu U, Kasifoglu T, Tufan A (2020) Familial Mediterranean fever is associated with a wide spectrum of inflammatory disorders: results from a large cohort study. Rheumatol Int 40(1):41–48. https://doi.org/10.1007/s00296-019-04412-7
Babaoglu H, Armagan B, Bodakci E, Satis H, Atas N, Sari A et al (2020) Factors associated with damage in patients with familial Mediterranean fever. Clin Exp Rheumatol
Ozen S, Demirkaya E, Erer B, Livneh A, Ben-Chetrit E, Giancane G, Ozdogan H, Abu I, Gattorno M, Hawkins PN, Yuce S, Kallinich T, Bilginer Y, Kastner D, Carmona L (2016) EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis 75(4):644–651. https://doi.org/10.1136/annrheumdis-2015-208690
Satiş H, Armağan B, Bodakçi E, Ataş N, Sari A, Yaşar Bilge N et al (2020) Colchicine intolerance in FMF patients and primary obstacles for optimal dosing. Turk J Med Sci 50(5):1337–1343. https://doi.org/10.3906/sag-2001-261
Tufan A, Lachmann HJ (2020) Familial Mediterranean fever, from pathogenesis to treatment: a contemporary review. Turk J Med Sci 50(SI-2):1591–1610. https://doi.org/10.3906/sag-2008-11
Hentgen V, Vinit C, Fayand A, Georgin-Lavialle S (2020) The use of interleukine-1 inhibitors in familial Mediterranean fever patients: a narrative review. Front Immunol 11:971. https://doi.org/10.3389/fimmu.2020.00971
Gignac MA, Badley EM, Lacaille D, Cott CC, Adam P, Anis AH (2004) Managing arthritis and employment: making arthritis-related work changes as a means of adaptation. Arthritis Care Res 51(6):909–916
Varan O, Kucuk H, Babaoglu H, Atas N, Salman RB, Satis H, Ozturk MA, Haznedaroglu S, Goker B, Tufan A (2019) Effect of interleukin-1 antagonists on the quality of life in familial Mediterranean fever patients. Clin Rheumatol 38(4):1125–1130. https://doi.org/10.1007/s10067-018-4384-8
Pras M (1998) Familial Mediterranean fever: from the clinical syndrome to the cloning of the pyrin gene: editorial review. Scand J Rheumatol 27(2):92–97
Ozen S, S. E, Ben-Chetrit E, Gattorno M, Gul A, Hashkes P, Kone-Paut I, Lachmann H, Tsitsami E, Twilt M, De Benedetti F, Kuemmerle-Deschner J (2019) Recommendation on colchicine dosing and definition of colchicine resistance/intolerance in the management of familial Mediterranean fever [abstract]. Arthritis Rheum 71(suppl 10)
Piram M, Kone-Paut I, Lachmann HJ, Frenkel J, Ozen S, Kuemmerle-Deschner J et al (2014) Validation of the auto-inflammatory diseases activity index (AIDAI) for hereditary recurrent fever syndromes. Ann Rheum Dis 73(12):2168–2173. https://doi.org/10.1136/annrheumdis-2013-203666
Ter Haar NM, Annink KV, Al-Mayouf SM, Amaryan G, Anton J, Barron KS et al (2017) Development of the autoinflammatory disease damage index (ADDI). Ann Rheum Dis 76(5):821–830. https://doi.org/10.1136/annrheumdis-2016-210092
Reilly MC, Zbrozek AS, Dukes EM (1993) The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 4(5):353–365. https://doi.org/10.2165/00019053-199304050-00006
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483
Zhang W, Bansback N, Boonen A, Young A, Singh A, Anis AH (2010) Validity of the work productivity and activity impairment questionnaire--general health version in patients with rheumatoid arthritis. Arthritis Res Ther 12(5):R177. https://doi.org/10.1186/ar3141
Reilly MC, Gooch KL, Wong RL, Kupper H, van der Heijde D (2010) Validity, reliability and responsiveness of the Work Productivity and Activity Impairment Questionnaire in ankylosing spondylitis. Rheumatology (Oxford) 49(4):812–819. https://doi.org/10.1093/rheumatology/kep457
Claudepierre P, Van den Bosch F, Sarzi-Puttini P, Vastesaeger N, Govoni M, Kachroo S (2019) Treatment with golimumab or infliximab reduces health resource utilization and increases work productivity in patients with ankylosing spondylitis in the QUO-VADIS study, a large, prospective real-life cohort. Int J Rheum Dis 22(6):995–1001. https://doi.org/10.1111/1756-185X.13526
Garris C, Oglesby A, Sulcs E, Lee M (2013) Impact of systemic lupus erythematosus on burden of illness and work productivity in the United States. Lupus 22(10):1077–1086. https://doi.org/10.1177/0961203313498795
Mandel MD, Bálint A, Lovász BD, Gulácsi L, Strbák B, Golovics PA et al (2014) Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics. Eur J Health Econ 15(Suppl 1):S121–S128. https://doi.org/10.1007/s10198-014-0603-7
Hoving JL, Bartelds GM, Sluiter JK, Sadiraj K, Groot I, Lems WF, Dijkmans BAC, Wijbrandts CA, Tak PP, Nurmohamed MT, Voskuyl AE, Frings-Dresen MHW (2009) Perceived work ability, quality of life, and fatigue in patients with rheumatoid arthritis after a 6-month course of TNF inhibitors: prospective intervention study and partial economic evaluation. Scand J Rheumatol 38(4):246–250. https://doi.org/10.1080/03009740902748264
Deodhar AA, Dougados M, Baeten DL, Cheng-Chung Wei J, Geusens P, Readie A, Richards HB, Martin R, Porter B (2016) Effect of secukinumab on patient-reported outcomes in patients with active ankylosing spondylitis: a phase III randomized trial (MEASURE 1). Arthritis Rheum 68(12):2901–2910. https://doi.org/10.1002/art.39805
Atas N, Varan O, Babaoglu H, Satis H, Bilici Salman R, Celik B, Tufan A, Haznedaroglu S, Goker B, Ozturk MA (2019) Work productivity in patients with Behçet disease and its association with disease activity and quality of life. Br J Occup Ther 82(6):376–382
Maksymowych WP, Gooch KL, Wong RL, Kupper H, van der Heijde D (2010) Impact of age, sex, physical function, health-related quality of life, and treatment with adalimumab on work status and work productivity of patients with ankylosing spondylitis. J Rheumatol 37(2):385–392. https://doi.org/10.3899/jrheum.090242
Sağ S, Nas K, Sağ MS, Tekeoğlu İ, Kamanlı A (2018) Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis. J Back Musculoskelet Rehabil 31(3):499–505. https://doi.org/10.3233/bmr-169657
Babaoglu H, Varan O, Kucuk H, Atas N, Satis H, Salman R, Ozturk MA, Haznedaroglu S, Goker B, Tufan A (2019) On demand use of anakinra for attacks of familial Mediterranean fever (FMF). Clin Rheumatol 38(2):577–581. https://doi.org/10.1007/s10067-018-4230-z
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Suticen, E., Atas, N., Guler, A.A. et al. Work productivity impairment in patients with familial Mediterranean fever and effects of interleukin-1 antagonists. Clin Rheumatol 40, 2865–2871 (2021). https://doi.org/10.1007/s10067-021-05617-7
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DOI: https://doi.org/10.1007/s10067-021-05617-7