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Work participation is reduced during the development of RA, months before clinical arthritis manifests
OBJECTIVES: We investigated whether work participation is affected in patients with arthralgia during transition to RA. Arthralgia patients with symptom resolution and early RA patients at diagnosis were used as a reference. METHODS: Three groups of patients were studied: arthralgia patients convert...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157058/ https://www.ncbi.nlm.nih.gov/pubmed/34698809 http://dx.doi.org/10.1093/rheumatology/keab793 |
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author | Rogier, Cleo de Jong, Pascal H P van der Helm-van Mil, Annette H M van Mulligen, Elise |
author_facet | Rogier, Cleo de Jong, Pascal H P van der Helm-van Mil, Annette H M van Mulligen, Elise |
author_sort | Rogier, Cleo |
collection | PubMed |
description | OBJECTIVES: We investigated whether work participation is affected in patients with arthralgia during transition to RA. Arthralgia patients with symptom resolution and early RA patients at diagnosis were used as a reference. METHODS: Three groups of patients were studied: arthralgia patients converting to RA (n = 114), arthralgia patients with spontaneous symptom resolution (n = 57), and early RA patients (n = 617). Both presenteeism (i.e. working while sick, scale 0–10) and absenteeism (i.e. sick leave) were taken into account. Work ability 1 year prior to clinical arthritis was estimated (in absolute numbers). The course of work restriction over time was studied using linear mixed models (β coefficient; delta per month) within each patient group. RESULTS: One-year prior to the development of clinical arthritis, mean presenteeism was 7.0 (95% CI 5.8, 8.1) in patients with arthralgia, indicating 30% loss, and further worsened to 6.1 (95% CI 5.3, 6.6) at RA diagnosis, thus indicating 39% loss. In early RA patients, presenteeism improved over time after DMARD initiation (β 0.052 per month 95% CI 0.042, 0.061, P < 0.0001). Presenteeism also improved in arthralgia patients who achieved spontaneous symptom resolution (β 0.063 per month, 95% CI 0.024, 0.10, P = 0.002). Absenteeism did not change significantly in arthralgia patients, but did improve in RA after DMARD-start. ACPA stratification revealed similar results. CONCLUSION: In the months preceding RA, presenteeism was already apparent, and it worsened further during progression to clinical arthritis and diagnosis. This underlines the relevance of the symptomatic pre-RA phase for patients. The observed reversibility in arthralgia patients with symptom resolution may suggest that intervention in pre-RA could improve work participation. |
format | Online Article Text |
id | pubmed-9157058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91570582022-06-04 Work participation is reduced during the development of RA, months before clinical arthritis manifests Rogier, Cleo de Jong, Pascal H P van der Helm-van Mil, Annette H M van Mulligen, Elise Rheumatology (Oxford) Clinical Science OBJECTIVES: We investigated whether work participation is affected in patients with arthralgia during transition to RA. Arthralgia patients with symptom resolution and early RA patients at diagnosis were used as a reference. METHODS: Three groups of patients were studied: arthralgia patients converting to RA (n = 114), arthralgia patients with spontaneous symptom resolution (n = 57), and early RA patients (n = 617). Both presenteeism (i.e. working while sick, scale 0–10) and absenteeism (i.e. sick leave) were taken into account. Work ability 1 year prior to clinical arthritis was estimated (in absolute numbers). The course of work restriction over time was studied using linear mixed models (β coefficient; delta per month) within each patient group. RESULTS: One-year prior to the development of clinical arthritis, mean presenteeism was 7.0 (95% CI 5.8, 8.1) in patients with arthralgia, indicating 30% loss, and further worsened to 6.1 (95% CI 5.3, 6.6) at RA diagnosis, thus indicating 39% loss. In early RA patients, presenteeism improved over time after DMARD initiation (β 0.052 per month 95% CI 0.042, 0.061, P < 0.0001). Presenteeism also improved in arthralgia patients who achieved spontaneous symptom resolution (β 0.063 per month, 95% CI 0.024, 0.10, P = 0.002). Absenteeism did not change significantly in arthralgia patients, but did improve in RA after DMARD-start. ACPA stratification revealed similar results. CONCLUSION: In the months preceding RA, presenteeism was already apparent, and it worsened further during progression to clinical arthritis and diagnosis. This underlines the relevance of the symptomatic pre-RA phase for patients. The observed reversibility in arthralgia patients with symptom resolution may suggest that intervention in pre-RA could improve work participation. Oxford University Press 2021-10-26 /pmc/articles/PMC9157058/ /pubmed/34698809 http://dx.doi.org/10.1093/rheumatology/keab793 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Science Rogier, Cleo de Jong, Pascal H P van der Helm-van Mil, Annette H M van Mulligen, Elise Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title | Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title_full | Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title_fullStr | Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title_full_unstemmed | Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title_short | Work participation is reduced during the development of RA, months before clinical arthritis manifests |
title_sort | work participation is reduced during the development of ra, months before clinical arthritis manifests |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157058/ https://www.ncbi.nlm.nih.gov/pubmed/34698809 http://dx.doi.org/10.1093/rheumatology/keab793 |
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