title: Work disability rates in RA. Results from an inception cohort with 24 years follow-up.
abstract: OBJECTIVE
  To explore rates of and reasons for work disability in an early RA cohort with median 10 years follow-up.
  
  
  METHODS
  One thousand four hundred and sixty patients with early RA (<2 years symptom duration) and no prior DMARD therapy were recruited from nine rheumatology outpatient departments across the UK between 1986 and 1998. Standard clinical, laboratory and radiological assessments were recorded at 6-monthly and yearly intervals. Assessment of employment included details of type and hours of paid work. The main outcomes investigated were rates of and main reasons for work cessation, analysed by age of onset of RA (<45, 45-60 years) and year of recruitment to the study (before or after 1992).
  
  
  RESULTS
  Maximum follow-up was 24 years, median 10 years. Of 647 patients in paid work at baseline, the majority were <60 years old (91%). The estimated probability of stopping work due to RA was highest in patients with older age of onset (45-60 years) who were recruited before 1992, but improved in those recruited from 1992 to 1998 (P < 0.01). There was no difference seen over the study recruitment years in younger age of onset patients.
  
  
  CONCLUSIONS
  Work loss related to RA occurred much earlier than for other reasons, especially in the first 5 years of RA, but improved in the later recruitment period. Work disability is multifactorial, and the gradual changes in therapies used over time in this cohort may be one explanation for the secular differences seen.
authors.affiliation: Department of Rheumatology, St Albans City Hospital, Waverley Road, St Albans AL3 5PN, UK.
authors.forename: Elena
authors.initials: E
authors.lastname: Nikiphorou
authors.forename: Daphne
authors.initials: D
authors.lastname: Guh
authors.forename: Nick
authors.initials: N
authors.lastname: Bansback
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Josh
authors.initials: J
authors.lastname: Dixey
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Adam
authors.initials: A
authors.lastname: Young
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D001688:Biological Products / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations / Q000145:classification; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products