Prognostic Factors for Permanent Work Disability in Patients With Rheumatoid Arthritis Who Received Combination Therapy of Conventional Synthetic Disease-Modifying Antirheumatic Drugs

Vazquez-Villegas, Maria Luisa; Gámez-Nava, Jorge I.; Celis, Alfredo; Sanchez-Mosco, Dalia; Cerda-Trujillo, Liliana Faviola De la; Murillo-Vázquez, Jessica Daniela; Saldaña-Cruz, Ana Miriam; Alcaraz-López, Miriam Fabiola; Díaz-Rizo, Valeria; Álvarez-Nemegyei, José; Cardiel, Mario H.; González-López, Laura

doi:10.1097/rhu.0000000000000582

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…There is an increasing body of evidence to study the effect of disability in the different setting of daily life such as paid and unpaid work, leisure, quality of life and participation. Some Mexican authors could show a different impact on these different dimensions of daily life [28]. 25% of RA patients had a permanent work disability after 10 years of treatment with disease modifying drugs.…”

Section: Resultsmentioning

confidence: 99%

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Ren¹,

Zhang²,

ZG³

et al. 2018

J Rheum Dis Treat

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Background: Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease whose etiopathogenesis is largely unknown. Available treatments, though effective, are insufficient in so far as there is no cure for a major proportion of patients. In those patients the disease becomes chronic with progressive joint damage, disability, and limitation of participation. Current treatment approaches include pain-relieving drugs and anti-inflammatory medications that slow joint damage, combined with physical therapies involving a well-balanced, highly personalized sequence of rest and exercise. As pain-relief, overall activity, mobility and participation are vital indicators of disability and response to RA treatment, regular patient feedback in this respect is key to a successful monitoring of the long-term effect of therapy. To manage such feedback, we have developed an easyto-use self-assessment tool "Activity Index" (AI) for tablets and smartphones that enables regular assessments of RA improvement and/or deterioration in the patients' home environment. In this normative study we addressed the questions of (1) The AI sensitivity regarding the resolution of small between-patient differences; and (2) The external validity of the AI instrument when compared with "objective" laboratory and x-ray measures and the HAQ disability index.

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Section: Resultsmentioning

confidence: 99%

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Ren¹,

Zhang²,

ZG³

et al. 2018

J Rheum Dis Treat

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“…Disease duration also played a significant role as a predictor of employment outcomes [33,36,45,71,77,86,102,111]. Longer disease duration correlate with decreased employment likelihood, which could be attributed to older age and increased joint damage and disability in patients with longer-standing RA.…”

Section: Key Findingsmentioning

confidence: 98%

Employment of patients with rheumatoid arthritis - a systematic review and meta-analysis

Kirkeskov,

Bray

2023

BMC Rheumatol

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Background Patients with rheumatoid arthritis (RA) have difficulties maintaining employment due to the impact of the disease on their work ability. This review aims to investigate the employment rates at different stages of disease and to identify predictors of employment among individuals with RA. Methods The study was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines focusing on studies reporting employment rate in adults with diagnosed RA. The literature review included cross-sectional and cohort studies published in the English language between January 1966 and January 2023 in the PubMed, Embase and Cochrane Library databases. Data encompassing employment rates, study demographics (age, gender, educational level), disease-related parameters (disease activity, disease duration, treatment), occupational factors, and comorbidities were extracted. Quality assessment was performed employing Newcastle–Ottawa Scale. Meta-analysis was conducted to ascertain predictors for employment with odds ratios and confidence intervals, and test for heterogeneity, using chi-square and I2-statistics were calculated. This review was registered with PROSPERO (CRD42020189057). Results Ninety-one studies, comprising of a total of 101,831 participants, were included in the analyses. The mean age of participants was 51 years and 75.9% were women. Disease duration varied between less than one year to more than 18 years on average. Employment rates were 78.8% (weighted mean, range 45.4–100) at disease onset; 47.0% (range 18.5–100) at study entry, and 40.0% (range 4–88.2) at follow-up. Employment rates showed limited variations across continents and over time. Predictors for sustained employment included younger age, male gender, higher education, low disease activity, shorter disease duration, absence of medical treatment, and the absence of comorbidities. Notably, only some of the studies in this review met the requirements for high quality studies. Both older and newer studies had methodological deficiencies in the study design, analysis, and results reporting. Conclusions The findings in this review highlight the prevalence of low employment rates among patients with RA, which increases with prolonged disease duration and higher disease activity. A comprehensive approach combining clinical and social interventions is imperative, particularly in early stages of the disease, to facilitate sustained employment among this patient cohort.

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“…In developing countries, where many RA patients have economic restrictions to follow a subsequent therapy with biologic agents, the use of combined therapy with csDMARDs constitutes the most frequent therapeutic strategy [ 20 ]. Failure of combined therapy with csDMARDs is associated with worsening of the disease, radiological damage progression, and a high risk of permanent work disability [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Muscle Wasting in Women with Rheumatoid Arthritis: Relevance of the Persistent Failure of Conventional Combination Therapy

et al. 2022

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Background: Muscle wasting, also known as myopenia, is frequent in rheumatoid arthritis (RA). To date, it is still unknown if the failure of pharmacologic therapies increases the risk of myopenia in RA. Objective: To identify if treatment failure with conventional synthetic DMARDs (csDMARDs) constitutes an independent risk factor of muscle wasting in women with RA. Methods: This was a cross-sectional study. We included 277 women with RA. Assessments in RA patients included: clinical, epidemiological, and therapeutic variables. The skeletal muscle index (SMI) was estimated by DXA, and myopenia was diagnosed if they had an SMI < 5.45 kg/m2. Multivariable logistic regression models identified risk factors of myopenia. Results: Muscle wasting was observed in 28.2% of patients with RA. The risk factors of myopenia in RA were menopausal (OR: 4.45, 95% CI: 1.86 to 10.64) and failure of combined therapy with csDMARDs (OR: 2.42, 95% CI: 1.15 to 5.07). The increased body mass index was protective (OR:0.81, 95% CI: 0.75 to 0.87). Conclusions: Around one of four patients with RA presented muscle wasting. Muscle wasting is related to treatment failure of combined csDMARDs; other factors influencing the presence of muscle wasting is being postmenopausal, whereas, the body mass index was a protective factor.

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Prognostic Factors for Permanent Work Disability in Patients With Rheumatoid Arthritis Who Received Combination Therapy of Conventional Synthetic Disease-Modifying Antirheumatic Drugs

Cited by 7 publications

References 22 publications

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Employment of patients with rheumatoid arthritis - a systematic review and meta-analysis

Risk Factors of Muscle Wasting in Women with Rheumatoid Arthritis: Relevance of the Persistent Failure of Conventional Combination Therapy

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