Work disability in rheumatoid arthritis 10 years after the diagnosis

Objective. To describe employment status of patients with early rheumatoid arthritis (RA) 10 years after diagnosis; and to identify predictive and ass ociative factors related to permanent work disability. Methods. The study population consisted of 82 patients with early RA who we re gainfully employed at onset of RA. Patients were prospectively followed for an average of 10 years and were treated according to the "sawtooth" str ategy. Results. After a time since diagnosis of 2 and an average of 9.9 years, res pectively, 19/82 (19%) and 36/82 (44%) cases have been retired merely or pa rtly due to RA. Further, at the latest checkup 42/82 (51%) patients were st ill gainfully employed, while the prevalence of patients working full time under the common retirement age of 65 yrs was 58% (42/72), Cox regression a nalysis revealed that physically heavy work at baseline was the strongest i ndependent predictive factor for permanent work disability. Ten years after disease onset, however, work disabled patients had more severe disease tha n those who continued in work. Conclusion. Our study confirms that the working capacity of patients with R A is in danger from the very start. Despite early and active therapy with d isease modifying antirheumatic drugs, at 10 years the cumulative work disab ility prevalence was 44%.