Reisins S, Fifield J, Walsh S, Dauser D. Work disability among two cohorts of women with recent-onset rheumatoid arthritis: a survival analysis. Arthritis Rheum (Arthritis Care Res) 2007;57:372-80.

Rheumatoid arthritis (RA) frequently leaves a person unable to maintain a full-time paid job. Studies have shown that about half of all RA patients employed at disease onset leave the workforce within 10 years. With the advent of more aggressive and early treatment with disease-modifying antirheumatic drugs and biologic agents, the hope is that this rate of work disability is on the decline.

What Problem Was Studied?
Using grants from the Arthritis Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Susan Reisine, PhD, and colleagues at the University of Connecticut, Farmington, investigated the rates of work disability among women with recent-onset RA from two separate groups recruited to the study 10 years apart. Two questions were being studied: Do the greatest risk of work disability and functional decline occur early in the disease process? What factors most influenced work disability?

What Was Done in the Study?
Forty-eight employed women with early-onset RA (≤18 months’ duration) were recruited to the study in 1987-88. They were interviewed by telephone once per year for four years. Ninety-one employed women with early-onset RA were recruited in 1998 and were also interviewed annually for four years.

What Were the Study Results?
The research team found that women in the more recently recruited group had better overall clinical status, perhaps owing to the more aggressive treatments available to them. However, the self-reported pain levels were about the same for both groups. The work disability rates among the two groups were also similar: 31% and 26% for the 1987 and 1998 groups, respectively. They were able to determine that physical factors, including having more disease flares and a greater number of deformed joints, were most predictive of who would leave the workforce. Marital status was also found to be a significant factor in determining work disability. Married women had a greater tendency to leave the workforce than unmarried women, possibly due to financial considerations.

What Do These Results Mean for Women With RA?
A variety of factors contribute to the risk of work disability among people with RA. Various studies have identified physically demanding work, lack of autonomy (making your own decisions, setting your own work hours, etc.), worse pain, lower functional status, fewer years of education, more disease flares and more deformed joints all increase the risk of a person with RA leaving the workforce. Reisine encourages people with RA who want to stay on the job to collaborate with their employers to receive the job accommodations they need.

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