Background: Psoriasis and psoriatic arthritis (PsA) impair quality of life, including reduction in employment or job\nduties. The PRESTA (Psoriasis Randomized Etanercept STudy in Patients with Psoriatic Arthritis) study, a randomized,\ndouble-blind, two-dose trial, examined the efficacy of etanercept treatment in patients with moderate-to-severe\nplaque psoriasis and PsA and the main results have been presented previously. This analysis examined employment\nstatus, job duties and sick days, pre-defined endpoints in PRESTA, among this patient population.\nMethods: Participants (N = 752) were randomized to receive etanercept 50 mg twice weekly (BIW; n = 379) or 50 mg\nonce weekly (QW; n = 373) for 12 weeks by subcutaneous injection. All participants then received open-label\netanercept 50 mg QW for 12 additional weeks, while remaining blinded to the randomization. A pharmacoeconomic\nquestionnaire was administered at baseline, week 12 and week 24 of treatment. The questionnaire included\nemployment status and changing job responsibilities and sick time taken due to psoriasis or PsA. The statistical\nmethods included analysis of covariance, t-test, Fisherââ?¬â?¢s exact test and McNemarââ?¬â?¢s test. Last-observation-carried-forward\nimputation was used for missing data.\nResults: Employment was at least maintained from baseline to week 24 in both dose groups (56% [BIW/QW] and\n60% [QW/QW] at baseline, 61% and 60%, respectively, at week 24). Among employed participants, the proportion of\npatients whose job responsibilities changed due to PsA decreased significantly from baseline to week 24 (17ââ?¬â??23% to\n5ââ?¬â??8%; p < 0.01). Similar results were seen with job responsibility changes due to psoriasis (11ââ?¬â??14% to 4%; p < 0.01).\nThe number of monthly sick days also decreased from baseline to week 24 (2.4 days for both treatment groups to\n0.7 (BIW/QW) and 1.1 (QW/QW); p ? 0.03 for each). No significant differences between the treatment groups were\nobserved for any economic endpoint at any time point.\nConclusions: For patients with moderate-to-severe plaque psoriasis and PsA, etanercept treatment resulted in reducing\njob responsibility changes due to disease and in reducing sick time. Effective treatment of psoriasis and PsA may reduce\nmissed work days.
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