Working status in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: results from the British Society for Rheumatology Biologics Register.
OBJECTIVE
To describe working status in patients with RA, AS and PsA treated with anti-TNF therapy registered with the British Society for Rheumatology Biologics Register.


METHODS
Patients with RA (n = 3291), AS (n = 229) and PsA (n = 254) treated with anti-TNF therapy were included in this study. In addition, biologic-naive patients with RA (n = 379) were included. At baseline and 3 years after registration, all patients reported their working status. Baseline characteristics between working and work-disabled patients were compared. Logistic regression analysis was applied to identify factors associated with new work disability in patients with RA.


RESULTS
At baseline, work disability rates were already high: 49% for RA, 39% for PsA, 41% for AS and 36% for biologic-naive patients. Work-disabled patients had a higher HAQ score and worse disease activity than working patients. Working patients with a high HAQ score [odds ratio (OR) 2.79; 95% CI 1.89, 4.12] and a manual job (OR 2.31; 95% CI 1.52, 3.52) at baseline were more likely to become work disabled at follow-up, while those patients in remission 6 months after commencing anti-TNF therapy were less likely to become work disabled. However, use of anti-TNF therapy did not prevent patients with RA from becoming work disabled (OR for RA control patients vs RA anti-TNF patients 0.80; 95% CI 0.36, 1.81, adjusted for baseline variables).


CONCLUSIONS
A high percentage of patients with RA, AS and PsA were already work disabled at the start of anti-TNF therapy. There is less future work disability in working patients with RA who responded to anti-TNF therapy.
Verstappen
Suzanne M M
SM
ARC Epidemiology Unit, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK.
Watson
Kath D
KD
Lunt
Mark
M
McGrother
Katie
K
Symmons
Deborah P M
DP
Hyrich
Kimme L
KL
D000293:Adolescent; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012720:Severity of Illness Index; D025242:Spondylarthropathies / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006113:United Kingdom; D014937:Work; D014938:Work Capacity Evaluation; D055815:Young Adult
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha
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