title: Work disability is related to the presence of arthritis and not to a specific diagnosis. Results from a large early arthritis cohort in Argentina.
abstract: The objective of the study was to evaluate work disability and its main associated factors in patients with early arthritis. Argentine Consortium for Early Arthritis (CONAART) is the first early arthritis cohort in Argentina. Patients with one or more swollen joints and less than 2 years of symptoms duration were followed up prospectively in 13 departments of rheumatology. Social, demographic, familiar, clinical, and laboratory data were recollected. At first year and every year, X-rays of hands and feet were performed and working status and pharmaco-economic data were recollected. Work status (employed, unemployed, retired) and type of work were assessed by direct interview using a predesigned questionnaire. Eight hundred forty-eight patients were included, rheumatoid arthritis (RA) = 483 (57 %)and undifferentiated arthritis (UA) = 365 (43 %), 694 (81.8 %) were women, median age was 46 years (interquartile range (IQR) 35-55.7) and median symptoms duration 7 months (IQR 3-12). Patients with RA had significantly higher disease activity, worse functional capacity and quality of life, and more severe radiological damage compared to UA patients. However work disability (unemployed patient) was comparable between groups (RA = 21 % versus UA = 18.6 % p = NS). In both groups, unemployed patients had higher disease activity score of 28 joints (DAS28), worse Health Assessment Questionnaire (HAQ) values, and less years of formal education (p value <0.005 in all comparisons). Radiological damage was greater in unemployed patients but this difference did not reach statistical significance. In multivariate analysis, disease activity was the main variable associated with unemployment in both groups. Joint involvement was the main cause of work disability in this cohort of patients with early arthritis, independently of the final diagnosis.
  
  
  CONCLUSIONS
  1. Work disability is higher in patients with inflammatory arthritis as compared to the general population. 2. Prevalence of work disability is comparable among patients with undifferentiated and rheumatoid arthritis. 3. Disease activity is the main disease variable associated with work disability.
authors.affiliation: Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Echeverria 955, Buenos Aires, Argentina, gustavocitera@gmail.com.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Citera
authors.forename: Hernan Maldonado
authors.initials: HM
authors.lastname: Ficco
authors.forename: Rodolfo S Pérez
authors.initials: RS
authors.lastname: Alamino
authors.forename: Fernando Dal
authors.initials: FD
authors.lastname: Pra
authors.forename: Veronica
authors.initials: V
authors.lastname: Lencina
authors.forename: Luciana
authors.initials: L
authors.lastname: Casalla
authors.forename: Mariana
authors.initials: M
authors.lastname: Benegas
authors.forename: Oscar
authors.initials: O
authors.lastname: Rillo
authors.forename: Alberto
authors.initials: A
authors.lastname: Berman
authors.forename: Ana Lucia
authors.initials: AL
authors.lastname: Barbaglia
authors.forename: Veronica
authors.initials: V
authors.lastname: Bellomío
authors.forename: Maria Haye
authors.initials: MH
authors.lastname: Salinas
authors.forename: Ana C
authors.initials: AC
authors.lastname: Alvarez
authors.forename: Francisco
authors.initials: F
authors.lastname: Caeiro
authors.forename: Josefina
authors.initials: J
authors.lastname: Marcos
authors.forename: Adrian
authors.initials: A
authors.lastname: Salas
authors.forename: Antonio Catalán
authors.initials: AC
authors.lastname: Pellet
authors.forename: Lorena
authors.initials: L
authors.lastname: Techera
authors.forename: Anastasia
authors.initials: A
authors.lastname: Secco
authors.forename: Sergio
authors.initials: S
authors.lastname: Paira
authors.forename: Federico
authors.initials: F
authors.lastname: Ceccato
authors.forename: Zaida
authors.initials: Z
authors.lastname: Bedrán
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Soriano
authors.forename: Josefina
authors.initials: J
authors.lastname: Marin
authors.forename: Gabriela
authors.initials: G
authors.lastname: Salvatierra
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Crespo
mesh_terms: D000328:Adult; D001118:Argentina; D001168:Arthritis / Q000000981:diagnostic imaging / Q000453:epidemiology; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015331:Cohort Studies; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data*