Low disease activity in RA patients allowed longer work history

Patients with rheumatoid arthritis who experienced low disease activity and an end to radiological progression in the first year of the disease had a better chance to continue working during the next 15 years, according to recent study results.

Researchers studied 86 Finnish patients with early rheumatoid arthritis (RA) who were working or available to work at study entry. Patients were treated with disease-modifying antirheumatic drugs (DMARDs).

“RA-related retirement was studied in relation to early disease activity defined as the 28-joint disease activity score area under the curve (DAS28 AUC) during the first 12 months and the impact of early radiological progression from the baseline to year 1,” the researchers wrote.

Forty-three percent of patients who participated in a 15-year examination still were using DMARD therapy, and 29% also were using low-dose oral glucocorticoids.

Through Kaplan-Meier analysis, retirement due to RA was estimated at 7% (95% CI, 3-16) after 1 year, 14% (95% CI, 8-24) after 2 years, 21% (95% CI, 13-32) after 5 years, 37% (95% CI, 27-49) after 10 years and 47% (95% CI, 36-60) after 15 years. None of the patients with low disease activity (DAS28 AUC≤3.2) retired during the first 3 years. They also had lower retirement rates after 5 (10% vs. 28%), 10 (14% vs. 55%) and 15 years (27% vs. 64%) compared with patients with DAS28 AUC>3.2.

“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,” the researchers reported.

“This register data and the earlier results of the FIN-RACo [study] suggest the importance of early and intensive DMARD treatment to prevent work disability in RA,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

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Source: Tiippana-Kinnunen T. Clin Exp Rheumatol. 2014;32:88-94.