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Predictors of work disability after start of anti-TNF therapy in a national cohort of Swedish patients with rheumatoid arthritis : Does early anti-TNF therapy bring patients back to work?

Olofsson, Tor LU ; Petersson, I. F. LU ; Eriksson, J. K. LU ; Englund, M. LU ; Nilsson, Jan-Åke LU ; Geborek, P. LU ; Jacobsson, L. T H LU ; , ; Askling, J and Neovius, M (2017) In Annals of the Rheumatic Diseases 76(7). p.1245-1252
Abstract

Objectives To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Methods Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50%... (More)

Objectives To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Methods Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50% for patients with full work ability, and survival analyses conducted. Baseline predictors including disease duration, age, sex, education level, employment, Health Assessment Questionnaire, Disease Activity Score 28 and relevant comorbidities were estimated using Cox regression. Results During 3 years after anti-TNF start, the probability of regaining work ability for totally workdisabled patients was 35% for those with disease duration <5 years and 14% for disease duration ≥5 years (adjusted HR 2.1 (95% CI 1.4 to 3.2)). For patients with full work ability at bio-start, disease duration did not predict work ability loss. Baseline disability pension was also a strong predictor of work ability gain after treatment start. Conclusions A substantial proportion of work-disabled patients with RA who start anti-TNF therapy regain work ability. Those initiating treatment within 5 years of symptom onset have a more than doubled 3-year probability of regaining work ability compared with later treatment starts. This effect seems largely due to the impact of disease duration on disability pension status.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
76
issue
7
pages
1245 - 1252
publisher
British Medical Association
external identifiers
  • scopus:85010304589
  • wos:000403074400018
ISSN
0003-4967
DOI
10.1136/annrheumdis-2016-210239
language
English
LU publication?
yes
id
d57dbbe8-5644-4ed1-b98b-c98e236e7779
date added to LUP
2017-02-22 15:41:13
date last changed
2018-11-11 04:49:54
@article{d57dbbe8-5644-4ed1-b98b-c98e236e7779,
  abstract     = {<p>Objectives To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Methods Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50% for patients with full work ability, and survival analyses conducted. Baseline predictors including disease duration, age, sex, education level, employment, Health Assessment Questionnaire, Disease Activity Score 28 and relevant comorbidities were estimated using Cox regression. Results During 3 years after anti-TNF start, the probability of regaining work ability for totally workdisabled patients was 35% for those with disease duration &lt;5 years and 14% for disease duration ≥5 years (adjusted HR 2.1 (95% CI 1.4 to 3.2)). For patients with full work ability at bio-start, disease duration did not predict work ability loss. Baseline disability pension was also a strong predictor of work ability gain after treatment start. Conclusions A substantial proportion of work-disabled patients with RA who start anti-TNF therapy regain work ability. Those initiating treatment within 5 years of symptom onset have a more than doubled 3-year probability of regaining work ability compared with later treatment starts. This effect seems largely due to the impact of disease duration on disability pension status.</p>},
  author       = {Olofsson, Tor and Petersson, I. F. and Eriksson, J. K. and Englund, M. and Nilsson, Jan-Åke and Geborek, P. and Jacobsson, L. T H and ,  and Askling, J and Neovius, M},
  issn         = {0003-4967},
  language     = {eng},
  month        = {01},
  number       = {7},
  pages        = {1245--1252},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Predictors of work disability after start of anti-TNF therapy in a national cohort of Swedish patients with rheumatoid arthritis : Does early anti-TNF therapy bring patients back to work?},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2016-210239},
  volume       = {76},
  year         = {2017},
}