Does achieving clinical response prevent work stoppage or work absence among employed patients with early rheumatoid arthritis?

Rheumatology (Oxford). 2012 Feb;51(2):270-4. doi: 10.1093/rheumatology/ker189. Epub 2011 Jun 29.

Abstract

Objectives: 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.

Trial registration: ClinicalTrials.gov NCT00195494.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Employment / statistics & numerical data
  • Etanercept
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Male
  • Methotrexate / therapeutic use*
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Remission Induction
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Etanercept
  • Methotrexate

Associated data

  • ClinicalTrials.gov/NCT00195494