title: Comparison of employability outcomes among patients with early or long-standing rheumatoid arthritis.
abstract: OBJECTIVE
  To compare employability between patients with early and long-standing rheumatoid arthritis (RA) and examine the relationships between improvement in employability and disease stage after adjustment for demographic characteristics, disease activity, physical functioning, and response to therapy.
  
  
  METHODS
  We evaluated the employability data from 2 double-blind, randomized, placebo-controlled studies of infliximab plus methotrexate (MTX) in patients with RA. Patients were incomplete responders to MTX in 1 study and had never taken MTX in the other study. Patients age <65 years were categorized as having early RA (< or =3 years disease duration) or long-standing RA (>3 years disease duration). Physical functioning was assessed using the Health Assessment Questionnaire (HAQ) and clinical response was determined based on the American College of Rheumatology 20% improvement criteria (ACR20).
  
  
  RESULTS
  Patients with early RA were more likely to be employable at baseline than those with long-standing RA, even after adjusting for baseline HAQ scores. Among patients who were not employable at baseline but achieved an ACR20 response after 1 year of treatment, after adjusting for baseline HAQ score, the patients with early RA who had never taken MTX were 3 times more likely to become employable compared with those with long-standing RA who had an incomplete response to MTX at baseline.
  
  
  CONCLUSIONS
  In 2 clinical trials, patients with early RA were more likely to show improved employment outcomes after treatment than those with long-standing RA, suggesting intervention as early as possible in the disease course maximizes an individual patient's employment potential.
authors.affiliation: Centocor Research and Development, Malvern, Pennsylvania 19355, USA. chan3@cntus.jnj.com
authors.forename: Chenglong
authors.initials: C
authors.lastname: Han
authors.forename: Josef
authors.initials: J
authors.lastname: Smolen
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.forename: E William
authors.initials: EW
authors.lastname: St Clair
authors.forename: Daniel
authors.initials: D
authors.lastname: Baker
authors.forename: Mohan
authors.initials: M
authors.lastname: Bala
mesh_terms: D001172:Arthritis, Rheumatoid; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014937:Work