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Comparative Study
. 2025 Apr 12;45(5):96.
doi: 10.1007/s00296-025-05851-1.

Work productivity and activity impairment in patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: a comparative analysis from the POLNOR-Rheuma cohort

Piotr Kuszmiersz  1   2 , Zofia Guła  3   4 , Magdalena Strach  3   4 , Jarosław Nowakowski  3   4 , Grzegorz Biedroń  3   4 , Alen Brkic  5 , Glenn Haugeberg  5   6 , Mariusz Korkosz  3   4
Affiliations
Comparative Study

Work productivity and activity impairment in patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: a comparative analysis from the POLNOR-Rheuma cohort

Piotr Kuszmiersz et al. Rheumatol Int. .

Abstract

Rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) significantly impact patients' ability to work. This cross-sectional study investigated work productivity measured by the Work Productivity and Activity Impairment (WPAI) questionnaire in a real-world cohort of Polish patients with RA, PsA, and axSpA, and assessed sociodemographic and clinical factors related to productivity loss. Adult patients with RA, PsA, or axSpA were included from the POLNOR-Rheuma database. Work productivity was measured using the WPAI questionnaire. Disease activity, physical function, pain, fatigue, and other clinical variables were assessed. Multivariate linear regression models identified factors influencing work productivity impairment. Indirect costs were estimated using the human capital approach. 914 patients were analyzed (425 RA, 191 PsA, 298 axSpA). While overall work impairment was similar across diseases, RA and PsA patients had higher pain, disability, and activity impairment than axSpA. High disease activity was associated with greater impairments in presenteeism, work productivity, and activity (p < 0.05). Pain, fatigue, and disability strongly predicted WPAI scores. The country's annual indirect costs were estimated at €1.21 billion (€3,208 per patient), with absenteeism and presenteeism accounting for substantial losses. This study quantifies the substantial burden of RA, PsA, and axSpA on work productivity in Poland. The findings highlight the importance of effective disease control and comprehensive patient support to improve work outcomes and reduce societal costs. Future research should evaluate the long-term effects of targeted interventions on work participation in these conditions.

Keywords: Axial spondylarthritis; Health costs; Psoriatic arthritis; Rheumatoid arthritis; Work productivity.

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Conflict of interest statement

Declarations. Conflict of interest: None declared.

References

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    1. Veale DJ, Fearon U (2018) The pathogenesis of psoriatic arthritis. Lancet [Internet]. Jun 2 [cited 2024 Apr 27];391(10136):2273–84. Available from: https://pubmed.ncbi.nlm.nih.gov/29893226/
    1. Sieper J, Poddubnyy D (2017) Axial spondyloarthritis. Lancet [Internet]. Jul 1 [cited 2024 Apr 27];390(10089):73–84. Available from: https://pubmed.ncbi.nlm.nih.gov/28110981/
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