OBJECTIVES To evaluate work productivity of paid workers and homemakers with rheumatoid arthritis (RA) treated with adalimumab plus methotrexate (ADA+MTX), ADA monotherapy, or MTX monotherapy, and to determine baseline predictors of work outcomes. METHODS Data were from the DE032 companion study to PREMIER, a 2-year, randomized controlled trial of MTX-naïve patients with early RA (<3 years). Absenteeism (number of missed work days), presenteeism (patients' self-judgment of effects of RA on work performance), and employment status data were collected from self-reports at baseline and varying timepoints during the 2-year study. For analyses of cumulative variables, adjustments were made for duration of patients' participation in DE032. RESULTS Of 799 patients in PREMIER, 664 participated in DE032 (ADA+MTX, n=219; ADA monotherapy, n=231; MTX monotherapy, n=214). Percentages of paid workers and homemakers were similar across treatment groups. Among paid workers, the number of missed work days at Year 2 was significantly fewer for ADA+MTX (17.4 days) and ADA monotherapy (18.7 days) vs. MTX monotherapy (36.9 days, p<0.0001). Improvement in presenteeism was greater with ADA+MTX vs. MTX monotherapy (p<0.05 at most visits). The percentage of patients who retained or gained employment over the 2-year study was 57.6% (121 of 210) for ADA+MTX, 51.8% (116 of 224) for ADA monotherapy, and 47.6% (100 of 210) for MTX monotherapy. The odds of retaining/gaining employment were significantly greater for ADA+MTX vs. MTX monotherapy (odds ratio [OR]=1.53, 95% confidence interval [CI]: 1.04–2.26, p=0.032). Retaining/gaining employment was significantly associated with younger age, female sex, and better baseline scores on the Health Assessment Questionnaire, Short Form 36 Health Survey, and radiographic progression (joint space narrowing, joint erosion, total Sharp score). CONCLUSIONS ADA+MTX was associated with more positive work outcomes vs. MTX monotherapy. Productivity outcomes were similar for paid workers and homemakers. Radiographic progression at baseline was predictive of employment status.