title: Work disability in Finnish patients with rheumatoid arthritis: a 15-year follow-up.
abstract: OBJECTIVE
  To investigate long-term work disability of patients with early rheumatoid arthritis (RA) and to examine impact of early disease activity and radiological progression on the loss of final work capacity.
  
  
  METHODS
  Work disability due to RA was studied over 15 years in 86 Finnish patients with early RA and available for the labour force at study entry. RA-related retirement was studied in relation to early disease activity defined as the 28-joint disease activity score area under curve (DAS28 AUC) during the first 12 months and the impact of early radiological progression from the baseline to year 1.
  
  
  RESULTS
  The RA-related retirement rate was 7% after the first year, 11% after 2 years, 19% after 5 years, 33% after 10 years and 39% after 15 years. Of the patients with low disease activity (DAS28 AUC ≤3.2) none were retired during the first 3 years. The retirement rate was also lower in subsequent years (10% after 5 years, 14% after 10 years, and 27% after 15 years) among these patients compared to those with DAS28 AUC >3.2 (28%, 55%, and 64%, respectively). A similar trend was evident among patients with no radiological progression (≤1 unit increase in Larsen score) and those with >1 Larsen unit of progression during the first year of RA.
  
  
  CONCLUSIONS
  Our study suggests that low disease activity and halting of radiological progression during the first year of the disease improve possibilities to maintain work capacity in RA during the subsequent 15 years.
authors.affiliation: Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, Helsinki, P.O.Box 700, 00029 Helsinki, Finland. tarja.tiippana-kinnunen@hus.fi.
authors.forename: Tarja
authors.initials: T
authors.lastname: Tiippana-Kinnunen
authors.forename: Leena
authors.initials: L
authors.lastname: Paimela
authors.forename: Ritva
authors.initials: R
authors.lastname: Peltomaa
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Leena
authors.initials: L
authors.lastname: Laasonen
authors.forename: Marjatta
authors.initials: M
authors.lastname: Leirisalo-Repo
mesh_terms: D000041:Absenteeism; D000328:Adult; D000704:Analysis of Variance; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D001175:Arthrography; D016009:Chi-Square Distribution; D017281:Cost of Illness; D018450:Disease Progression; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012179:Retirement; D012307:Risk Factors; D012720:Severity of Illness Index; D018582:Sick Leave; D013997:Time Factors; D014938:Work Capacity Evaluation