EXTENDED REPORT

¹ Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
² Division of Rheumatology, Department of Internal Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
³ Division of Rheumatology, Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA

Correspondence to:
Dr G S Alarcón
Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, 830 Faculty Office Tower, 510, 20th Street South, Birmingham, AL 35294-3408, USA; graciela.alarcon{at}ccc.uab.edu

Objective: To examine the risk factors for self-reported work disability in patients from the LUpus in MInorities: NAture vs. Nurture cohort with systemic lupus erythematosus (SLE).

Methods: Patients with SLE of Hispanic (Texas and Puerto Rico), African American and Caucasian ethnicity were studied. Work disability was defined by patients’ self-report. Only patients known to be employed at the baseline visit were included. The probabilities of self-reporting work disability over time were examined by the Kaplan–Meier method; differences between ethnic groups were examined by the log-rank test. The relationship of baseline socioeconomic–demographic, clinical, behavioural and psychological features with work disability was examined by standard statistical tests. Variables with p0.10 in these analyses were examined by logistic regression.

Results: The rate of self-reported work disability among the 273 patients studied was 19% at 5 years; it was numerically higher for the African Americans (25%) than for the Hispanics from Texas (19%) and the Caucasians (18%). The rate for the Hispanics from Puerto Rico was 7% at 2 years; 5-year rates could not be estimated for this ethnic subgroup (shorter follow-up in the cohort). In the regression analysis, age, male sex, poverty, total disease duration, disease activity and damage accrual were predictors of work disability.

Conclusions: The rate of work disability was 19% at 5 years. Patients with SLE with more severe disease and with lower socioeconomic status are at high risk of becoming disabled. The toll SLE imposes could possibly be reduced in patients at risk if, in addition to medical treatment, services needed to overcome their disadvantageous socioeconomic status are provided.

Abbreviations: ACR, American College of Rheumatology; LUMINA, LUpus in MInority populations: Nature vs. Nurture; SLE, systemic lupus erythematosus

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Baker, K., Pope, J., Fortin, P., Silverman, E., Peschken, C., 1000 Faces of Lupus Investigators and CaNIOS (Cana, (2009). Work disability in systemic lupus erythematosus is prevalent and associated with socio-demographic and disease related factors. Lupus 18: 1281-1288 [Abstract]  
• CAMPBELL, R. Jr, COOPER, G. S., GILKESON, G. S. (2009). The Impact of Systemic Lupus Erythematosus on Employment. The Journal of Rheumatology 36: 2470-2475 [Abstract] [Full Text]  
• Baker, K., Pope, J. (2009). Employment and work disability in systemic lupus erythematosus: a systematic review. Rheumatology (Oxford) 48: 281-284 [Abstract] [Full Text]  
• Mok, C., Cheung, M., Ho, L., Yu, K., To, C. (2008). Risk and predictors of work disability in Chinese patients with systemic lupus erythematosus. Lupus 17: 1103-1107 [Abstract]  
• Alarcon, G. S (2008). Lessons from LUMINA: a multiethnic US cohort. Lupus 17: 971-976