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An ObserVatIonal STudy of the Effectiveness of AdaLimumab on Health and Disability Outcomes in New Zealand Patients With Immune-Mediated InflammaTorY Diseases (VITALITY)

An ObserVatIonal STudy of the Effectiveness of AdaLimumab on Health and Disability Outcomes in New Zealand Patients With Immune-Mediated InflammaTorY Diseases (VITALITY)

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT02451839
Acronym
VITALITY
Enrollment
168
Registered
2015-05-22
Start date
2015-07-06
Completion date
2017-12-05
Last updated
2019-06-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Crohn's Disease, Psoriasis, Rheumatoid Arthritis

Keywords

Crohn Disease, Arthritis, Rheumatoid, Psoriasis, Patient Outcome Assessment, Adalimumab, Global Health, Quality of Life

Brief summary

For public health purposes disability is becoming increasingly important as an outcome measure. Despite this, there are few data on the effectiveness of adalimumab on disability outcomes in patients with immune-mediated inflammatory diseases (IMIDs), particularly in the Phase IV setting. There are even less data available in New Zealand, which did not have the opportunity to participate to a major extent in large, multinational, Phase III pivotal studies of adalimumab in IMIDs. The World Health Organisation Disability Assessment Schedule (WHODAS) 2.0 is a simple, validated, free and easy-to-use generic assessment instrument for health and disability. It is applicable across cultures, in all adult populations. It is a responsive measure that can show what difference a treatment makes. Results from study of effect of adalimumab on WHODAS scores and other patient-reported outcomes (PROs) of work activity and well-being will be of interest to a variety of stakeholders in the healthcare system including patients, healthcare practitioners and payers.

Interventions

None listed

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

* Patients with a diagnosis of rheumatoid arthritis, Crohn's disease or psoriasis who have made a decision with their physician to commence treatment with adalimumab in accordance with routine medical practice and with the approved adalimumab New Zealand Datasheet. * Patients who have been evaluated for tuberculosis risk factors/exposure for active/latent tuberculosis infection (per local requirements and according to the approved adalimumab New Zealand Datasheet). * Adult subjects, 18-75 years old, who have voluntarily signed and dated an informed consent form prior to any study-specific procedures.

Exclusion criteria

* Previous treatment with adalimumab. * Previous treatment with any biologic. * Severe infection including sepsis, active tuberculosis or opportunistic infection. * Moderate to severe heart failure (New York Heart Association Class II/III). * Concurrent administration with anakinra. * Hypersensitivity to adalimumab or its excipients. * Any condition that in the opinion of the investigator would compromise the subject's well-being or ability to perform the study requirements.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in WHODAS 2.0 Response Score at Month 6 Across All IndicationsBaseline, Month 6WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Secondary

MeasureTime frameDescription
Change From Baseline in WHODAS 2.0 Response Score at Month 4 Across All IndicationsBaseline, Month 4WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.
Change From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Crohn's DiseaseBaseline, Month 6WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.
Change From Baseline in WHODAS 2.0 Response Score at Month 6 In Participants With PsoriasisBaseline, Month 6WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.
Change From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Rheumatoid ArthritisBaseline, Month 6WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.
Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: AbsenteeismBaseline, Month 6WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.
Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: PresenteeismBaseline, Month 6WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.
Change From Baseline in WPAI:GH 2.0 Score at Month 6 Across All Indications: Work Productivity LossBaseline, Month 6WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.
Change From Baseline in WHODAS 2.0 Response Score at Month 2 Across All IndicationsBaseline, Month 2WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.
Change From Baseline in K10 at Month 6 Across All IndicationsBaseline, Month 6The K10 is intended to yield a global measure of distress based on a questionnaire about anxiety and depressive symptoms that a person has experienced in the most recent 4 week period. The K10 scale involves 10 questions about emotional states each with a 5-level response scale. Each item is scored from 1=none of the time to 5=all of the time. Scores of the 10 items are then summed, yielding a minimum score of 10 and a maximum score of 50. Low scores indicate low levels of psychological distress and high scores indicate high levels of psychological distress.
Change From Baseline in Flourishing Scale at Month 6 Across All IndicationsBaseline, Month 6The Flourishing Scale is a brief 8-item summary measure of the respondent's self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score. Participants are asked to respond to 8 statements using a scale of 1 (strongly disagree) and 7 (strongly agree) for each item. The possible range of scores is from 8 (lowest possible) to 56 (highest possible), with higher scores representing more psychological resources and strengths.
Change From Baseline in Subjective Vitality Scale at Month 6 Across All IndicationsBaseline, Month 6The Subjective Vitality Scale assesses the state of feeling alive and alert to having energy available to the self. Patients respond to eight prompts, with a response ranging from 1=strongly disagree to 7=strongly agree. The sum of the scores is calculated with a higher score indicating a better condition. The total score ranges from 8 to 56 with a higher score indicating a better condition.
Change From Baseline in HAQ-DI Score at Month 6 in Participants With Rheumatoid ArthritisBaseline, Month 6HAQ-DI measures functional status in rheumatic diseases. It has 20 items, and asks patients to report the degree of difficulty faced in several areas of their life including: dressing and grooming, arising, eating, walking, hygiene, reach, grip, activities based on the previous week on a scale from 0 (without any difficulty) to 3 (cannot be done at all). It also asks the participant to rate their pain and health in the previous week. Scores on each task are summed and averaged to provide an overall score ranging from 0 (no disability) to 3 (very severe, high-dependency disability).
Change From Baseline in SIBDQ Score at Month 6 in Participants With Crohn's DiseaseBaseline, Month 6The SIBDQ is a simple validated, 10-item questionnaire designed to find out how the patient has been feeling in the previous 2 weeks. QoL is measured in 4 domains: bowel symptoms, emotional health, systemic systems and social function. Participants respond to questions ranging from 1=all of the time to 7=none of the time. Scores are added together, with higher scores indicating a better health-related QoL. Total scores range from 10 (poor QoL) to 70 (good QoL).
Change From Baseline in DLQI Score at Month 6 in Participants With PsoriasisBaseline, Month 6The DLQI measures 10 items covering the following topics: symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, and treatment, to determine how much the patients skin problem affected their life in the past week. Participants respond to the questions with 'very much,' 'a lot,' 'a little,' or 'not at all.' The scores are added together, and the impact on QoL is banded as follows: 0-1=no effect on participant's life; 2-5=small effect; 6-10=moderate effect; 11-20=very large effect; 21-30=extremely large effect.
Number of Participants Remaining on Treatment at Month 6Month 6The number of participants at 6 months who remained on adalimumab, having satisfied the requirements for application for renewal of subsidy by special authority.
Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Activity ImpairmentBaseline, Month 6WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.

Participant flow

Pre-assignment details

Of the 168 recruited participants, 4 withdrew or were withdrawn prior to baseline measures being completed (164 participants had baseline World Health Organization Disability Assessment Schedule \[WHODAS\] data recorded).

Participants by arm

ArmCount
All Indications
Participants with Crohn's disease, rheumatoid arthritis, or psoriasis. All participants received at least 3 months of treatment with adalimumab. Adalimumab was prescribed by the physician under usual and customary practice and according to the approved adalimumab New Zealand Datasheet.
164
Total164

Baseline characteristics

CharacteristicAll Indications
Age, Continuous45.7 years
Dermatology Life Quality Index (DLQI) Score15.8 units on a scale
STANDARD_DEVIATION 7.5
Flourishing Scale45.0 units on a scale
STANDARD_DEVIATION 9
Health Assessment Questionnaire Disability Index (HAQ-DI)1.9 units on a scale
STANDARD_DEVIATION 0.6
Kessler Psychological Distress Scale (K10)23.0 units on a scale
STANDARD_DEVIATION 8.2
Race/Ethnicity, Customized
Asian
5 Participants
Race/Ethnicity, Customized
European
145 Participants
Race/Ethnicity, Customized
Maori
7 Participants
Race/Ethnicity, Customized
Other (Not Specified)
4 Participants
Race/Ethnicity, Customized
Pacific Peoples
3 Participants
Sex: Female, Male
Female
103 Participants
Sex: Female, Male
Male
61 Participants
Short Inflammatory Bowel Disease Questionnaire (SIBDQ)36.1 units on a scale
STANDARD_DEVIATION 9.7
Subjective Vitality Scale25.4 units on a scale
STANDARD_DEVIATION 7.4
Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH) V2.0: Absenteeism14.7 percentage of work time missed
STANDARD_DEVIATION 30
World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Response Score
All Indications
15.2 units on a scale
STANDARD_DEVIATION 9.1
World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Response Score
Crohn's disease
13.2 units on a scale
STANDARD_DEVIATION 7.3
World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Response Score
Psoriasis
14.4 units on a scale
STANDARD_DEVIATION 11.7
World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Response Score
Rheumatoid arthritis
17.9 units on a scale
STANDARD_DEVIATION 8.1
WPAI-GH v2.0: Activity Impairment51.9 percentage of activity impairment
STANDARD_DEVIATION 28.1
WPAI-GH v2.0: Presenteeism39.7 percentage impairment time
STANDARD_DEVIATION 28.8
WPAI-GH v2.0: Work Productivity Loss29.4 percentage overall work impairment
STANDARD_DEVIATION 22.5

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
1 / 164
other
Total, other adverse events
65 / 164
serious
Total, serious adverse events
18 / 164

Outcome results

Primary

Change From Baseline in WHODAS 2.0 Response Score at Month 6 Across All Indications

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 6 Across All Indications7.9 units on a scaleStandard Deviation 8.1
p-value: <0.001paired t-test
Secondary

Change From Baseline in DLQI Score at Month 6 in Participants With Psoriasis

The DLQI measures 10 items covering the following topics: symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, and treatment, to determine how much the patients skin problem affected their life in the past week. Participants respond to the questions with 'very much,' 'a lot,' 'a little,' or 'not at all.' The scores are added together, and the impact on QoL is banded as follows: 0-1=no effect on participant's life; 2-5=small effect; 6-10=moderate effect; 11-20=very large effect; 21-30=extremely large effect.

Time frame: Baseline, Month 6

Population: Participants with psoriasis and baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in DLQI Score at Month 6 in Participants With Psoriasis11.0 score on a scaleStandard Deviation 7.6
p-value: <0.001paired t-test
Secondary

Change From Baseline in Flourishing Scale at Month 6 Across All Indications

The Flourishing Scale is a brief 8-item summary measure of the respondent's self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score. Participants are asked to respond to 8 statements using a scale of 1 (strongly disagree) and 7 (strongly agree) for each item. The possible range of scores is from 8 (lowest possible) to 56 (highest possible), with higher scores representing more psychological resources and strengths.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in Flourishing Scale at Month 6 Across All Indications-2.3 units on a scaleStandard Deviation 8.7
p-value: 0.006paired t-test
Secondary

Change From Baseline in HAQ-DI Score at Month 6 in Participants With Rheumatoid Arthritis

HAQ-DI measures functional status in rheumatic diseases. It has 20 items, and asks patients to report the degree of difficulty faced in several areas of their life including: dressing and grooming, arising, eating, walking, hygiene, reach, grip, activities based on the previous week on a scale from 0 (without any difficulty) to 3 (cannot be done at all). It also asks the participant to rate their pain and health in the previous week. Scores on each task are summed and averaged to provide an overall score ranging from 0 (no disability) to 3 (very severe, high-dependency disability).

Time frame: Baseline, Month 6

Population: Participants with rheumatoid arthritis baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in HAQ-DI Score at Month 6 in Participants With Rheumatoid Arthritis0.4 score on a scaleStandard Deviation 0.4
p-value: <0.001paired t-test
Secondary

Change From Baseline in K10 at Month 6 Across All Indications

The K10 is intended to yield a global measure of distress based on a questionnaire about anxiety and depressive symptoms that a person has experienced in the most recent 4 week period. The K10 scale involves 10 questions about emotional states each with a 5-level response scale. Each item is scored from 1=none of the time to 5=all of the time. Scores of the 10 items are then summed, yielding a minimum score of 10 and a maximum score of 50. Low scores indicate low levels of psychological distress and high scores indicate high levels of psychological distress.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in K10 at Month 6 Across All Indications6.1 units on a scaleStandard Deviation 7.7
p-value: <0.001paired t-test
Secondary

Change From Baseline in SIBDQ Score at Month 6 in Participants With Crohn's Disease

The SIBDQ is a simple validated, 10-item questionnaire designed to find out how the patient has been feeling in the previous 2 weeks. QoL is measured in 4 domains: bowel symptoms, emotional health, systemic systems and social function. Participants respond to questions ranging from 1=all of the time to 7=none of the time. Scores are added together, with higher scores indicating a better health-related QoL. Total scores range from 10 (poor QoL) to 70 (good QoL).

Time frame: Baseline, Month 6

Population: Participants with Crohn's disease and baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in SIBDQ Score at Month 6 in Participants With Crohn's Disease-16.3 score on a scaleStandard Deviation 13.7
p-value: <0.001paired t-test
Secondary

Change From Baseline in Subjective Vitality Scale at Month 6 Across All Indications

The Subjective Vitality Scale assesses the state of feeling alive and alert to having energy available to the self. Patients respond to eight prompts, with a response ranging from 1=strongly disagree to 7=strongly agree. The sum of the scores is calculated with a higher score indicating a better condition. The total score ranges from 8 to 56 with a higher score indicating a better condition.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in Subjective Vitality Scale at Month 6 Across All Indications-5.4 units on a scaleStandard Deviation 8.3
p-value: <0.001paired t-test
Secondary

Change From Baseline in WHODAS 2.0 Response Score at Month 2 Across All Indications

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 2

Population: Participants with baseline and Month 2 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 2 Across All Indications5.7 units on a scaleStandard Deviation 8
p-value: <0.001paired t-test
Secondary

Change From Baseline in WHODAS 2.0 Response Score at Month 4 Across All Indications

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 4

Population: Participants with baseline and Month 4 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 4 Across All Indications7.1 units on a scaleStandard Deviation 8.4
p-value: <0.001paired t-test
Secondary

Change From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Crohn's Disease

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 6

Population: Participants with Crohn's disease and baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Crohn's Disease6.3 units on a scaleStandard Deviation 7.3
p-value: <0.001paired t-test
Secondary

Change From Baseline in WHODAS 2.0 Response Score at Month 6 In Participants With Psoriasis

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 6

Population: Participants with psoriasis and baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 6 In Participants With Psoriasis8.1 units on a scaleStandard Deviation 8.9
p-value: <0.001paired t-test
Secondary

Change From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Rheumatoid Arthritis

WHODAS 2.0 is a measures health and disability across cultures in all adult populations by assessing the same individual before and after the intervention across 12 items, covering the following 6 domains: cognition, mobility, self-care, getting along, life activities and participation. Scores assigned to each of the items (none=0, mild=1, moderate=2, severe=3, and extreme=4) are summed. Scores can range from 0 to 48. Persons scoring 10 to 48 are likely to have clinically significant disability.

Time frame: Baseline, Month 6

Population: Participants with rheumatoid arthritis and baseline and Month 6 assessments.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WHODAS 2.0 Response Score at Month 6 in Participants With Rheumatoid Arthritis9.5 units on a scaleStandard Deviation 8.3
p-value: <0.001paired t-test
Secondary

Change From Baseline in WPAI:GH 2.0 Score at Month 6 Across All Indications: Work Productivity Loss

WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WPAI:GH 2.0 Score at Month 6 Across All Indications: Work Productivity Loss9.7 percentage overall work impairmentStandard Deviation 28
p-value: 0.006paired t-test
Secondary

Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Absenteeism

WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Absenteeism10.6 percentage of work time missedStandard Deviation 34.7
p-value: 0.015paired t-test
Secondary

Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Activity Impairment

WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Activity Impairment24.1 percentage of activity imparimentStandard Deviation 34
p-value: <0.001paired t-test
Secondary

Change From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Presenteeism

WPAI:GH is a 6-item questionnaire looks at the effect of health problems on ability to work and perform regular activities. The WPAI yields 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work / reduced on-the-job effectiveness), work productivity loss (overall work impairment / absenteeism plus presenteeism) and activity impairment. WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. The questionnaire specifies responses for the previous 7 days.

Time frame: Baseline, Month 6

Population: Participants with baseline and Month 6 assessments. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (MEAN)Dispersion
All IndicationsChange From Baseline in WPAI:GH V2.0 Score at Month 6 Across All Indications: Presenteeism18.0 percentage impairment timeStandard Deviation 33.1
p-value: <0.001paired t-test
Secondary

Number of Participants Remaining on Treatment at Month 6

The number of participants at 6 months who remained on adalimumab, having satisfied the requirements for application for renewal of subsidy by special authority.

Time frame: Month 6

Population: Participants completing the study at 6 months. Per protocol, primary and secondary endpoint data \[other than the endpoints presented in Outcome Measures 4-6 and 14-16\] were intended to be analyzed across all indications; therefore, data are presented for all participants as a single group.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
All IndicationsNumber of Participants Remaining on Treatment at Month 6108 Participants

Source: ClinicalTrials.gov · Data processed: Feb 21, 2026