Factors affecting employment in Japanese patients with ankylosing spondylitis (AS)

Ankylosing spondylitis (AS) often affects individuals during their most productive working years. However, few studies have investigated factors influencing employment in Japanese AS patients. This study investigates the employment status and related factors in Japanese patients with ankylosing spondylitis.

This cross-sectional study included 81 Japanese patients with ankylosing spondylitis who met the modified New York criteria. Patient characteristics, disease activity and employment data were collected. Work productivity was assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire. Employment was defined as working 20 or more hours per week. Statistical tests included Mann-Whitney U and chi-squared/Fisher's exact tests (p < 0.05).

The employment rate was 71.6%. WPAI scores indicated absenteeism of 2.1%, presenteeism of 21.6%, work impairment of 22.2% and activity impairment of 32.7%. Both the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were significantly higher in unemployed than employed patients (BASDAI: 4.95 vs. 2.58, p = 0.005; BASFI: 4.95 vs. 1.45, p = 0.001). There were no significant differences in C-reactive protein, Ankylosing Spondylitis Disease Activity Score (ASDAS), and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) between the groups.

Compared to global averages, the employment rate among Japanese patients with ankylosing spondylitis is relatively high. Patient-reported outcomes, BASDAI and BASFI, were more closely associated with employment status than objective disease measures, highlighting the importance of addressing functional limitations to improve work outcomes.

Not applicable.