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The Prevalence and Incidence of Work Disability in Rheumatoid Arthritis, and the Effect of Anti-Tumor Necrosis Factor on Work Disability
FREDERICK WOLFE, SARALYNN ALLAIRE, and KALEB MICHAUD
ABSTRACT. Methods. Participants with RA who were employed when RA was diagnosed (N = 8082) were evaluated for up to 5.5 years. Work disability incidence rates were determined in a subset (N = 4155) of those who stated they were currently employed, and the effect of anti-TNF therapy was determined by conditional logistic regression, after adjustment for covariates. Results. At a median of 12.8 years after RA onset, 56.2% were still employed and 43.8% were not working. Of those not working, 22.7% considered themselves disabled. In addition, 30.5% had stopped work over their lifetimes for health reasons and 20.6% were currently receiving Social Security disability benefits. The annualized incidence rate for self-reported disability was 2.5% and for Social Security disability 1.9%. The incidence rate for persons who stopped working and did not resume employment was 4.0%. Anti-TNF therapy was not associated with Social Security disability, but was associated with an increased risk of self-reported disability (odds ratio 1.6) after adjustment for covariates. Conclusion. Rates of self-reported disability were lower than noted in previous studies, perhaps reflecting overall improvement in RA therapy. We could not discern a positive effect of anti-TNF therapy on the risk of work disability. (First Release Sept 1 2007; J Rheumatol 2007;34:2211-7) Key Indexing Terms:
RHEUMATOID ARTHRITIS From the National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine, Wichita, Kansas; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; and University of Nebraska Medical Center, Omaha, Nebraska, USA. F. Wolfe, MD, National Data Bank for Rheumatic Disease and University of Kansas School of Medicine; S. Allaire, ScD, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; K. Michaud, PhD, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases. Address correspondence to Dr. F. Wolfe, National Data Bank for Rheumatic Diseases, 1035 N. Emporia, Suite 230, Wichita, KS 67214. E-mail: fwolfe@arthritis-research.org Accepted for publication June 21, 2007. |
