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Work disability remains a major problem in rheumatoid arthritis in the 2000’s

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Abstract

Background: Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also as or more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries.

Methods: The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K USD per capita) and 16 low-GDP countries (<11K USD) was analyzed for work and disability status at onset and over the course of RA, and clinical status of patients who continued working or had stopped working in high-GDP vs. low-GDP countries according to all RA Core data Set measures. Associations of a work disability status with RA Core Data Set variables and indices were analyzed using descriptive statistics and regression analyses.

Results: At the time of first symptoms, 86% of men (range 57%-100% among countries) and 64% (19%-87%) of women <65 years were working. More than one-third (37%) of these patients reported subsequent work disability because of RA. Among 1,756 patients whose symptoms had began during the 2000’s, the probability of continuing to work was 80% (95%CI 78%-82%) at 2 years and 68% (95% CI 65%-71%) at 5 years, with similar patterns in high-GDP and low-GDP countries. Patients who continued working vs. stopped working had significantly better clinical status for all clinical status measures and patient self-report scores, with similar patterns in high-GDP and low-GDP countries. However, patients who had stopped working in high-GDP countries had better clinical status than patients who continued working in low-GDP countries. The most significant identifier of work disability in all subgroups was HAQ functional disability score.

Conclusions: Work disability rates remain high among people with RA during this millennium. In low-GDP countries, people remain working with high levels of disability and disease activity. Cultural and economic differences between societies affect work disability as an outcome measure for RA.

Rheumatoid arthritis and work disability (UAE data included), United Arab Emirate data was used in this study by Tuulikki Sokka of Arkisto/Tutkijat, Jyväskylä Central Hospital, 40620 Jyväskylä, Finland, Phone: +358 40 735 2087; Fax +358 14 2691 275, email: tuulikki.sokka@ksshp.fi

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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