Severe impairments in work ability among patients with axSpA and PsA: results from the RABBIT-SpA Register

To assess the frequency and extent of work ability impairment and explore differences in its degree in relation to sociodemographic, clinical and patient-reported factors in patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).

This cross-sectional analysis used data from the prospective RABBIT-SpA cohort, including patients aged 18-65 years with physician-confirmed axSpA or PsA. Work ability was assessed in both the axSpA and PsA cohorts using the Work Ability Index (WAI; 7-49 points, higher scores=better work ability), categorised as good/excellent (≥37) or moderate/poor (≤36) according to validated cut-offs. Patients were grouped as employed with good/excellent WAI, employed with moderate/poor WAI or non-employed. Descriptive analyses were conducted.

2655 patients were analysed (axSpA: 1366; PsA: 1276). In the axSpA cohort, 80% were employed, with 70% reporting moderate/poor WAI (mean 31.6, SD: 7.6). Among patients with PsA, 69% were employed, of whom 71% reported moderate/poor WAI (mean 31.4, SD: 8.1).For both the axSpA and PsA cohorts, compared with individuals with good/excellent WAI, those who were non-employed or had moderate/poor WAI were more often female, older, obese, smokers and had fewer years of education.Individuals with lower inflammatory markers, fewer comorbidities and lower disease activity were mainly in the good/excellent WAI group, while non-employed individuals showed the poorest clinical and patient-reported factors, followed by those with moderate/poor WAI.

Around 25% of patients of working age with axSpA and PsA were non-employed and two-thirds of employed patients reported moderate/poor work ability. The results underline the importance of enhanced focus on occupational health in rheumatology to identify at-risk patients early.