RESEARCH - Predictors of productivity loss in early RA: a 5 year follow up study

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ls of the Rheumatic Diseases 2005;64:130-133

© 2005 by BMJ Publishing Group Ltd & European League Against Rheumatism

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CONCISE REPORT

Predictors of productivity loss in early rheumatoid arthritis: a 5 year

follow up study

K Puolakka1, H Kautiainen2, T Möttönen3, P Hannonen4, M Hakala2, M Korpela5,

K Ilva6, U Yli-Kerttula5, H Piirainen7 and M Leirisalo-Repo7 for the

FIN-RACo Trial Group

1 Department of Medicine, Lappeenranta Central Hospital, Lappeenranta,

Finland

2 Rheumatism Foundation Hospital, Heinola, Finland

3 Department of Medicine, Turku University Central Hospital, Turku, Finland

4 Department of Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland

5 Department of Medicine, Tampere University Hospital, Tampere, Finland

6 Department of Medicine, Hämeenlinna Central Hospital, Hämeenlinna, Finland

7 Division of Rheumatology, Department of Medicine, Helsinki University

Central Hospital, Helsinki, Finland

Correspondence to:

Dr K Puolakka

Department of Medicine, Lappeenranta Central Hospital, Valto Käkelän katu 1,

FIN-53130 Lappeenranta, Finland; kari.puolakka@...

ABSTRACT

Objective: To explore baseline risk factors for productivity loss and work

disability over 5 years in patients with early, active RA.

Patients and methods: In the FIN-RACo trial, 195 patients with recent onset

RA were randomised to receive either a combination of DMARDs with

prednisolone or a single DMARD for 2 years. At baseline, 162 patients were

working or available for work. After 5 years' follow up, data on sick leave

and retirement were obtained from social insurance registers or case

records. The cumulative duration of sick leaves and RA related disability

pensions was counted for each patient. To analyse predictors of productivity

loss, the patients were divided into four groups according to duration of

work disability per patient year.

Results: Patient's and physician's global assessment of RA severity 50 and

HAQ score 1.0 were risk factors for extension of productivity loss (OR (95%

(CI) 1.77 (1.00 to 3.16), 1.85 (1.03 to 3.32), and 1.78 (1.01 to 3.14),

respectively). Additional risk factors were low education level (2.40 (1.18

to 4.88)) and older age (1.03 (1.00 to 1.06)); combination treatment was a

protective factor (0.59 (0.35 to 0.99)).

Conclusion: At baseline, the risk of future productivity loss is best

predicted by education level, age, global assessments of RA severity, and

HAQ score.

http://ard.bmjjournals.com/cgi/content/abstract/64/1/130

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