AB1193 WORK INSTABILITY AMONG POLISH RHEUMATOID ARTHRITIS PATIENTS
Authors: W. Schmidt, M. Tapolska, M. Owczarek, K. Pawlak-Bus, P. Leszczynski
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rheumatoid arthritis (RA) affects patients’ capacity to work. Rheumatoid Arthritis Work Instability Scale (RA-WIS) is a reliable method to measure work instability (WI) (1–3). We lack data on relationship between RA and work instability among Polish patients. Objectives: The aim of our study was to assess WI and associated factors among patients with RA. Methods: 315 patients from three rheumatology centres were enrolled and filled questionnaires including demographic and self-reported clinical data, RA-WIS, and The Health Assessment Questionnaire (HAQ). Swollen and tender joints count (SJC, TJC) were assessed by attending physician and current erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. We excluded 41 patients due to incorrectly filled form and analysed questionnaires of 274 patients. DAS28 (Disease Activity Score in 28 joints) and DAS28-CRP were calculated. We performed statistical analysis with Statistica v. 13.3 using Mann-Whitney U test, chi-square test and Spearman’s correlation Results: 140 (51 %) patients were employed and their characteristics are presented on Table 1. In univariable analysis we identified following risk factors for high risk WI: moderate-to-high disease activity (DAS28≥3.2 – OR 2.29, 95%CI 1.06-4.96, p=0.033; DAS28-CRP≥3.2 – OR 2.34, 95%CI 1.04-5.27, p=0.038), ESR ≥30 mm/h in women and ≥20 mm/h in men (OR 2.65, 95%CI 1.20-5.89, p=0.010), CRP≥1mg/dL (OR 4.02, 95%CI 1.78-9.10 p&lt;0.001), HAQ-DI&gt;1.0 (OR 2.23, 95%CI 1.04-4.81, p=0.037) and at least moderate pain on visual analogue scale (VASp ≥4.5 cm - OR 5.31, 95%CI 2.36-11.96, p&lt;0.001). Correlations were moderate between RA-WIS and VASp (R S =0.59, p&lt;0.001) and HAQ-DI (R S =0.52, p&lt;0.001) whereas weak with disease activity indices (DAS28 - R S =0.31, p&lt;0.001; DAS28-CRP - R S =0.28, p&lt;0.001). Table 1. Demographic and clinical characteristics of employed patients according to work instability risk, N(%) or mean(±SD). Characteristic RA-WIS score low-to-moderate (0-17) high (&gt;17) Patients 94 (67.1%) 46 (32.9%) Sex, female 73 (77.7%) 38 (82.6%) Age (years) 47.9 (±11.8) 50.4 (±9.3) Disease duration (years) 13.0 (±8.4) 14.0 (±8.7) RF, positive 68 (72.3%) 34 (73.9%) ACPA, positive 59 (62.8%) 29 (63.0%) ESR (mm/h) 18.3 (±16.0) 28.2 (± 21.9)* CRP (mg/dL) 0.6 (± 1.0) 1.1 (± 1.0)* TJC 4.5 (±4.0) 7.6(±6.3)* SJC 2.7 (±3.0) 5.2(±5.5)* HAQ-DI 0.7 (±0.5) 1.1 (±0.5)* pain - VAS 10 cm 3.9 (±1.9) 6.5 (± 2.2)* DAS28 3.5 (±1.2) 4.2 (±1.4)* DAS28-CRP 3.9 (±1.0) 4.3 (±1.2)* WI – work instability, RA-WIS – Rheumatoid Arthritis Work Instability Scale, RF – rheumatoid factor in IgM class, ACPA – anti-citrullinated protein antibodies, ESR – erythrocyte sedimentation rate, CRP – C-reactive protein, TJC – tender joints count, SJC – swollen joints count, HAQ-DI – Heath Assessment Questionnaire Disability Index, VAS – visual analogue scale, DAS28 – Disease Activity Score in 28 joints *p&lt;0.05, Mann-Whitney U test Conclusion: Pain and disability are main factors associated with work instability among patients with RA. References: [1]Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, et al. Development of a work instability scale for rheumatoid arthritis. Arthritis Rheum. 2003;49(3):349–54. [2]Gilworth G, Emery P, Gossec L, Vlieland TPMV, Breedveld FC, Hueber AJ, et al. Adaptation and cross-cultural validation of the rheumatoid arthritis work instability scale (RA–WIS). Ann Rheum Dis. 2009;68(11):1686–90. [3]Revicki D, Ganguli A, Kimel M, Roy S, Chen N, Safikhani S, et al. Reliability and Validity of the Work Instability Scale for Rheumatoid Arthritis. Value Health J Int Soc Pharmacoeconomics Outcomes Res. 2015;18(8):1008–15. Disclosure of Interests: None declared