Work disability remains a major problem in rheumatoid arthritis in the 2000s: Data from 32 countries in the QUEST-RA Study

Tuulikki Sokka, Hannu Kautiainen, Theodore Pincus, Suzanne M.M. Verstappen, Amita Aggarwal, Rieke Alten, Daina Andersone, Humeira Badsha, Eva Baecklund, Miguel Belmonte, Jürgen Craig-Müller, Licia Maria Henrique da Mota, Alexander Dimic, Nihal A. Fathi, Gianfranco Ferraccioli, Wataru Fukuda, Pál Géher, Feride Gogus, Najia Hajjaj-Hassouni, Hisham HamoudGlenn Haugeberg, Dan Henrohn, Kim Horslev-Petersen, Ruxandra Ionescu, Dmitry Karateew, Reet Kuuse, Ieda Maria Magalhaes Laurindo, Juris Lazovskis, Reijo Luukkainen, Ayman Mofti, Eithne Murphy, Ayako Nakajima, Omondi Oyoo, Sapan C. Pandya, Christof Pohl, Denisa Predeteanu, Mjellma Rexhepi, Sylejman Rexhepi, Banwari Sharma, Eisuke Shono, Jean Sibilia, Stanislaw Sierakowski, Fotini N. Skopouli, Sigita Stropuviene, Sergio Toloza, Ivo Valter, Anthony Woolf, Hisashi Yamanaka

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Introduction: Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also 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 US dollars (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 versus low-GDP countries according to all RA Core Data Set measures. Associations of 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 begun during the 2000s, the probabilities of continuing to work were 80% (95% confidence interval (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 versus 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 Health Assessment Questionnaire (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.

Original languageEnglish
Article numberR42
JournalArthritis Research and Therapy
Issue number2
Publication statusPublished - Mar 12 2010

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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    Sokka, T., Kautiainen, H., Pincus, T., Verstappen, S. M. M., Aggarwal, A., Alten, R., Andersone, D., Badsha, H., Baecklund, E., Belmonte, M., Craig-Müller, J., da Mota, L. M. H., Dimic, A., Fathi, N. A., Ferraccioli, G., Fukuda, W., Géher, P., Gogus, F., Hajjaj-Hassouni, N., ... Yamanaka, H. (2010). Work disability remains a major problem in rheumatoid arthritis in the 2000s: Data from 32 countries in the QUEST-RA Study. Arthritis Research and Therapy, 12(2), [R42].