Sick leave and disability pension before and after initiation of antirheumatic therapies in clinical practice

Abstract

Sick leave and disability pension increased rapidly before the initiation of antirheumatic therapy, which was associated with a halt but not a reversal of this development. Work ability is a metric of importance for clinical practice, signalling large remaining needs in the RA population, and the need for intervention earlier in the disease process.

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?

“…However, that study had a strictly descriptive approach and was not designed to specifically analyse predictors of work ability 7. Concerning disease duration as a predictor of work ability loss our results are consistent with findings by Verstappen et al 11 and Wolfe et al ,12 showing no such association.…”

“…In addition, it could indicate groups of patients with a poorer work prognosis who might benefit from early non-pharmacological interventions. Until now, such reports have been scarce with a few findings suggesting that short disease duration at anti-TNF start could have a favourable effect on future ability to work 7 10. Higher Health Assessment Questionnaire (HAQ) and older age at bio-start have been associated with a less favourable work prognosis,11–13 but larger predictor studies are needed.…”

Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)

“…Rheumatoid arthritis (RA) is a chronic disease where limitations and restrictions in everyday life are commonly experienced [1][2][3][4][5][6]. Medications for RA have developed greatly during the past century [7], and new biological agents have extensively reduced disability due to RA [8].…”

Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)

“…Because the disease mechanisms are now fairly well known, today's strategy of early pharmacological treatment and new biological drugs have lead to reduced disease activity and less disability compared to previously [4,5]. However, even in early RA many patients still report disability, implying a persistent need for rehabilitative interventions and medication, and probably also improvements of clinical reasoning with respect to rehabilitation strategies [3,6,7].…”