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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...

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Autores principales: Rogier, Cleo, de Jong, Pascal H P, van der Helm-van Mil, Annette H M, van Mulligen, Elise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
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.
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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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