title: The prevalence and incidence of work disability in rheumatoid arthritis, and the effect of anti-tumor necrosis factor on work disability.
abstract: OBJECTIVE
  To determine the prevalence and incidence rates of work disability in rheumatoid arthritis (RA), and to determine the effect of anti-tumor necrosis factor (TNF) therapy on work disability.
  
  
  METHODS
  Participants with RA who were employed when RA was diagnosed (N = 8082) were evaluated for up to 5.5 years. Work disability incidence rates were determined in a subset (N = 4155) of those who stated they were currently employed, and the effect of anti-TNF therapy was determined by conditional logistic regression, after adjustment for covariates.
  
  
  RESULTS
  At a median of 12.8 years after RA onset, 56.2% were still employed and 43.8% were not working. Of those not working, 22.7% considered themselves disabled. In addition, 30.5% had stopped work over their lifetimes for health reasons and 20.6% were currently receiving Social Security disability benefits. The annualized incidence rate for self-reported disability was 2.5% and for Social Security disability 1.9%. The incidence rate for persons who stopped working and did not resume employment was 4.0%. Anti-TNF therapy was not associated with Social Security disability, but was associated with an increased risk of self-reported disability (odds ratio 1.6) after adjustment for covariates.
  
  
  CONCLUSIONS
  Rates of self-reported disability were lower than noted in previous studies, perhaps reflecting overall improvement in RA therapy. We could not discern a positive effect of anti-TNF therapy on the risk of work disability.
authors.affiliation: National Data Bank for Rheumatic Diseases, 1035 N. Emporia, Wichita, KS 67214, USA. fwolfe@arthritis-research.org
authors.forename: Frederick
authors.initials: F
authors.lastname: Wolfe
authors.forename: Saralynn
authors.initials: S
authors.lastname: Allaire
authors.forename: Kaleb
authors.initials: K
authors.lastname: Michaud
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018582:Sick Leave; D012943:Social Security; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014481:United States; D014938:Work Capacity Evaluation