Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


The Proportion of Patients with Work Disability (WD) Is in Early Inflammatory Arthritis: Results From the CATCH Cohort

Mussen1,  L., Bykerk2,  V., Haraoui3,  B., Hitchon4,  C., Jamal5,  S., Pope6,  J.

University of Western Ontario, London, ON
Mt Sinai Hospital, Toronto, ON
Institut de Rhumatolgie de Montreal, Montreal, QC
University of Manitoba, Winnipeg, MB
St. Michael's Hospital, Toronto
St Joseph Health Care, London, ON

Purpose:

It is known that WD is high in established RA and ranges from 30 to 50%. The prevalence of WD in early RA (ERA) and early inflammatory arthritis (EIA) has not been well established.

Method:

Data from 655 patients enrolled since July 2007 were collected from the Canadian Early Arthritis Cohort (CATCH) study, a multi-centre observational prospective cohort of patients with EIA. Inclusion Criteria: age >16, symptom duration of 6–52 weeks of persistent synovitis, >=2 effused joints or 1 swollen MCP or PIP +>=1 of: positive RF, positive anti-CCP, morning stiffness >45 mins, response to NSAIDs, or a painful MTP squeeze test. 69% are identified as having RA (CRA criteria). At their first visit, patients were asked about employment status with possible answers including employed, retired, unemployed, on sick leave (SL), work disabled, on maternity leave, in school or a homemaker. The Dictionary of Occupational Titles (DOT) was used to determine the physical demands of each type of employment.

Results:

54% were employed, 22% retired, and 6% reported WD or SL, with the remaining 18% homemakers, students or on maternity leave. Patients who were neither employed nor on WD/SL were excluded from analysis, and baseline characteristics of the remaining 391 are given in the table below. 86% of the employed were in jobs with sedentary or light physical demands. Patients were further classified according to those who met the ACR criteria for ERA and those who did not (designated as EIA). WD/SL was not significantly different in EIA vs ERA (3.9% vs 7.1%, p=0.1). Factors associated with WD/SL in the group of 391 as a whole included TJC, DAS28 and SF-12, whereas SJC, RF and anti-CCP did not differ significantly between the WD/SL and the employed. Factors associated with WD in subgroup analysis were similar to the group overall with the exception of DAS-28, which differed significantly between the employed and WD/SL in ERA only.

 EmployedWD/SL
N35140
Age (SE)47 (0.6)47 (2.3)
% female74%68%
% positive RF57%58%
% meeting ACR criteria for RA68%80%
DAS-CRP4.7 (0.1)5.4 (0.2)
TJC (0–28)8.3 (0.4)11.9 (1.1)
SJC (0–28)7.3 (0.4)8.2 (1.0)
Standard Error of mean reported in brackets.

Conclusion:

WD is low at entry into an ERA cohort and thus there is a chance to intervene effectively in the care of patients early to prevent WD from occuring. As in established RA, WD was related to patient factors, HAQ, damage and disease activity. Both in patients meeting ACR criteria for ERA and those whose disease activity classifies as EIA, WD is especially related to TJC, DAS-28 and SF-12, and elevation in these parameters may indicate a point at which intervention may prevent WD. Although, p=NS, there appears to be more baseline WD in those who met ERA criteria and as the cohort grows, this may become significant.

To cite this abstract, please use the following information:
Mussen, L., Bykerk, V., Haraoui, B., Hitchon, C., Jamal, S., Pope, J.; The Proportion of Patients with Work Disability (WD) Is in Early Inflammatory Arthritis: Results From the CATCH Cohort [abstract]. Arthritis Rheum 2009;60 Suppl 10 :964
DOI: 10.1002/art.26041

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