RA-related work-disability rates were similar in the USA and European countries .
An apparent decrease in the prevalence of RA-related work disability since the 1970s may be related to a decrease in physically dem and ing work rather than to epidemiologic changes in RA .
The majority of the literature addresses permanent disability and temporary work loss ; none of the studies review ed reported the effect of RA on presenteeism , i.e. work limitation from the employer perspective , and there are few published studies of the effectiveness of disease-modifying anti-rheumatic drugs in reducing work-related productivity loss
BACKGROUND Rheumatoid arthritis ( RA ) is a chronic , debilitating disease with a significant impact on workplace productivity .
AIM To perform a systematic review of studies of the relationship between RA and reduced  workplace productivity .
Which patients stop working because of rheumatoid arthritis? Results of five years' follow up in 732 patients from the Early RA Study (ERAS)
Objectives : To assess the occurrence and prognostic factors for the ability to maintain paid work in patients with rheumatoid arthritis ( RA ) . Setting : Inception cohort of patients with RA recruited from rheumatology departments in nine NHS Hospital Trusts in Engl and . Patients : All consecutive patients with RA of less than two years ' duration , before any second line ( disease modifying ) drug treatment , and followed up for five years . Methods : Clinical , laboratory , and radiological assessment s , and all treatments were recorded prospect ively using a st and ardised format at presentation and yearly . Outcome measures : Changes in , and loss of paid work by five years ' follow up . Results : 732 patients completed the five year follow up . 353/721 ( 49 % ) were gainfully employed at the onset of RA , 211 ( 60 % ) were still working at five years , 104 ( 29 % ) stopped because of the disease , and 31 ( 9 % ) retired for reasons other than RA . Work disability at five years was more likely in manual workers ( odds ratio ( OR ) 2.3 , 95 % confidence interval ( CI ) 1.4 to 3.8 ) and worse baseline Health Assessment Question naire ( HAQ>1.5 , OR 2.26 , 95 % CI 1.38 to 3.7 ) . In combination with other baseline variables ( erythrocyte sedimentation rate , sex , age of onset , and radiological erosions ) , employment outcome was predicted in 78 % using multivariate analysis . Conclusions : Nearly half of the patients with RA were in paid employment at onset , work disability was an adverse outcome for a third of these patients by five years , and manual work and high baseline HAQ were important predictors for this . These details are likely to be useful to clinicians , health professionals , and patients in order to plan medical , orthopaedic , and remedial treatments in early RA . Future disease modifying treatments could be compared with this cohort of patients who were treated with conventional second line drugs
RA-related work-disability rates were similar in the USA and European countries .
An apparent decrease in the prevalence of RA-related work disability since the 1970s may be related to a decrease in physically dem and ing work rather than to epidemiologic changes in RA .
The majority of the literature addresses permanent disability and temporary work loss ; none of the studies review ed reported the effect of RA on presenteeism , i.e. work limitation from the employer perspective , and there are few published studies of the effectiveness of disease-modifying anti-rheumatic drugs in reducing work-related productivity loss
BACKGROUND Rheumatoid arthritis ( RA ) is a chronic , debilitating disease with a significant impact on workplace productivity .
AIM To perform a systematic review of studies of the relationship between RA and reduced  workplace productivity .