title: Does achieving clinical response prevent work stoppage or work absence among employed patients with early rheumatoid arthritis?
abstract: OBJECTIVE
  To evaluate the impact of clinical response on work stoppage or work absence among employed people with early RA.
  
  
  METHODS
  First-year data from the combination of MTX and etanercept trial was used. The analyses were restricted to the 205 patients working full or part time at baseline who answered questions on whether they stopped working or missed days from work in one or more of the four follow-up visits. Work stoppage referred to the first occurrence of subjects reporting stopping work. Work absence was defined as whether patients reported missed days from work. Clinical response and activity state considered included the ACR and European League against Rheumatism response criteria, 28-joint DAS (DAS-28) remission and the minimum clinically important difference of the HAQ score.
  
  
  RESULTS
  After adjustment for baseline characteristics, ACR70 responders were 72% less likely to stop working and 55% less likely to miss work than ACR20 non-responders (P < 0.05). Patients achieving DAS-28 remission were 54% less likely to stop work than those with DAS-28 > 3.2 (P < 0.05). Moderate improvements did not appear to effect work stoppage or missed days after adjustments.
  
  
  CONCLUSIONS
  Results suggest that achieving clinical remission or major improvement might be necessary to significantly impact work outcomes.
authors: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 620-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors: Wei
authors: W
authors: Zhang
authors: Huiying
authors: H
authors: Sun
authors: Paul
authors: P
authors: Emery
authors: Reiko
authors: R
authors: Sato
authors: Amitabh
authors: A
authors: Singh
authors: Bruce
authors: B
authors: Freundlich
authors: Aslam H
authors: AH
authors: Anis
mesh_terms: D000041:Absenteeism; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004651:Employment / Q000706:statistics & numerical data; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate