Work disability in rheumatoid arthritis 10 years after the diagnosis

To describe employment status of patients with early rheumatoid arthritis (RA) 10 years after diagnosis; and to identify predictive and associative factors related to permanent work disability.

The study population consisted of 82 patients with early RA who were gainfully employed at onset of RA. Patients were prospectively followed for an average of 10 years and were treated according to the "sawtooth" strategy.

After a time since diagnosis of 2 and an average of 9.9 years, respectively, 19/82 (19%) and 36/82 (44%) cases have been retired merely or partly due to RA. Further, at the latest checkup 42/82 (51%) patients were still gainfully employed, while the prevalence of patients working full time under the common retirement age of 65 yrs was 58% (42/72). Cox regression analysis revealed that physically heavy work at baseline was the strongest independent predictive factor for permanent work disability. Ten years after disease onset, however, work disabled patients had more severe disease than those who continued in work.

Our study confirms that the working capacity of patients with RA is in danger from the very start. Despite early and active therapy with disease modifying antirheumatic drugs, at 10 years the cumulative work disability prevalence was 44%.