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Predictors of productivity loss in early rheumatoid arthritis: a 5 year follow up study
  1. K Puolakka1,
  2. H Kautiainen2,
  3. T Möttönen3,
  4. P Hannonen4,
  5. M Hakala2,
  6. M Korpela5,
  7. K Ilva6,
  8. U Yli-Kerttula5,
  9. H Piirainen7,
  10. M Leirisalo-Repo7,
  11. for the FIN-RACo Trial Group
  1. 1Department of Medicine, Lappeenranta Central Hospital, Lappeenranta, Finland
  2. 2Rheumatism Foundation Hospital, Heinola, Finland
  3. 3Department of Medicine, Turku University Central Hospital, Turku, Finland
  4. 4Department of Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland
  5. 5Department of Medicine, Tampere University Hospital, Tampere, Finland
  6. 6Department of Medicine, Hämeenlinna Central Hospital, Hämeenlinna, Finland
  7. 7Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
  1. Correspondence to:
    Dr K Puolakka
    Department of Medicine, Lappeenranta Central Hospital, Valto Käkelän katu 1, FIN-53130 Lappeenranta, Finland;


Objective: To explore baseline risk factors for productivity loss and work disability over 5 years in patients with early, active RA.

Patients and methods: In the FIN-RACo trial, 195 patients with recent onset RA were randomised to receive either a combination of DMARDs with prednisolone or a single DMARD for 2 years. At baseline, 162 patients were working or available for work. After 5 years’ follow up, data on sick leave and retirement were obtained from social insurance registers or case records. The cumulative duration of sick leaves and RA related disability pensions was counted for each patient. To analyse predictors of productivity loss, the patients were divided into four groups according to duration of work disability per patient year.

Results: Patient’s and physician’s global assessment of RA severity ⩾50 and HAQ score ⩾1.0 were risk factors for extension of productivity loss (OR (95% (CI) 1.77 (1.00 to 3.16), 1.85 (1.03 to 3.32), and 1.78 (1.01 to 3.14), respectively). Additional risk factors were low education level (2.40 (1.18 to 4.88)) and older age (1.03 (1.00 to 1.06)); combination treatment was a protective factor (0.59 (0.35 to 0.99)).

Conclusion: At baseline, the risk of future productivity loss is best predicted by education level, age, global assessments of RA severity, and HAQ score.

  • CI, confidence interval
  • DMARD, disease modifying antirheumatic drug
  • ESR, erythrocyte sedimentation rate
  • HAQ, Health Assessment Questionnaire
  • HR, hazard ratio
  • OR, odds ratio
  • RA, rheumatoid arthritis
  • early rheumatoid arthritis
  • productivity loss
  • predictors
  • follow up study

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