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. 2022 May 5;61(5):2034-2042.
doi: 10.1093/rheumatology/keab607.

How do clinical and socioeconomic factors impact on work disability in early axial spondyloarthritis? Five-year data from the DESIR cohort

Elena Nikiphorou  1   2   3 , Annelies Boonen  4   5 , Bruno Fautrel  6 , Pascal Richette  7 , Robert Landewé  8   9 , Désirée van der Heijde  1 , Sofia Ramiro  1   8
Affiliations

How do clinical and socioeconomic factors impact on work disability in early axial spondyloarthritis? Five-year data from the DESIR cohort

Elena Nikiphorou et al. Rheumatology (Oxford). .

Abstract

Objectives: To investigate the impact of clinical and socioeconomic factors on work disability (WD) in early axial spondyloarthritis (axSpA).

Methods: Patients from the DESIR cohort with a clinical diagnosis of axSpA were studied over 5 years. Time to WD and potential baseline and time-varying predictors were explored, with a focus on socioeconomic (including ethnicity, education, job-type, marital/parental status) and clinical (including disease activity, function, mobility) factors. Univariable analyses, collinearity and interaction tests guided subsequent multivariable time-varying Cox survival analyses.

Results: From 704 patients eligible for this study, the estimated incidence of WD among those identified as at risk (n = 663, 94%), and across the five years of DESIR, was 0.05 (95% CI 0.03, 0.06) per 1000 person-days. Significant differences in baseline socioeconomic factors, including lower educational status and clinical measures, including worse disease activity, were seen in patients developing WD over follow-up, compared with those who never did. In the main multivariable model, educational status was no longer predictive of WD, whereas the AS disease activity score (ASDAS) and the BASFI were significantly and independently associated with a higher hazard of WD [HR (95%CI) 1.79 (1.27, 2.54) and 1.42 (1.22, 1.65), respectively].

Conclusion: WD was an infrequent event in this early axSpA cohort. Nevertheless, clinical factors were among the strongest predictors of WD, over socioeconomic factors, with worse disease activity and function independently associated with a higher hazard of WD. Disease severity remains a strong predictor of adverse work outcome even in early disease, despite substantial advances in therapeutic strategies in axSpA.

Keywords: adverse work outcomes; axSpA; disease activity; socioeconomic factors; work disability.

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References

    1. Boonen A, Sieper J, van der Heijde D. et al. The burden of non-radiographic axial spondyloarthritis. Semin Arthritis Rheum 2015;44:556–62. - PubMed
    1. Nikiphorou E, Ramiro S.. Work disability in axial spondyloarthritis. Curr Rheumatol Rep 2020;22:55. - PMC - PubMed
    1. Kiltz U, Kiefer D, Boonen A.. (Health-Related) quality of life as an outcome in studies of axial spondyloarthritis. Rheum Dis Clin North Am 2020;46:379–93. - PubMed
    1. Haywood KL, Garratt AM, Dziedzic K, Dawes PT.. Patient centered assessment of ankylosing spondylitis-specific health related quality of life: evaluation of the patient generated index. J Rheumatol 2003;30:764–73. - PubMed
    1. Bryngelson A. Long-term sickness absence and social exclusion. Scand J Public Health 2009;37:839–45. - PubMed

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