POS1012 WORK PRODUCTIVITY IMPAIRMENT IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: T. Shimada, J. Kikuchi, K. Hiramoto, H. Fukui, S. Saito, H. Hanaoka, Y. Kaneko
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with systemic lupus erythematosus (SLE) are thought to have a higher rate of work productivity impairment than healthy individuals [1]. Previous studies estimated that 20-50% of the patients have some types of work productivity impairment. However, the associated factors with work disability including absenteeism and presenteeism is not well known. <h3>Objectives:</h3> To elucidate the work productivity impairment and its associated factors among patients with SLE. <h3>Methods:</h3> We enrolled 317 patients with SLE who visited our department between May 2021 and January 2023. We evaluated work productivity impairment based on Work Productivity and Activity Impairment (WPAI) questionnaire [2]. We collected their background, medications, patient-reported outcomes (patient-visual analog scale [Pt-VAS] and Lupus Impact Tracker [LIT] [3]), physician global assessment (PGA), disease activity (SLEDAI and BILAG), and SLICC/ACR Damage Index (SDI), then analyzed cross-sectionally. <h3>Results:</h3> 317 patients were evaluated cross-sectionally. The median age was 50 (IQR 39–62), 289 (91%) were female, and the disease duration was 17 (IQR 7-28) years. 233 (74%) received prednisolone, and 245 (77%) received immunosuppressants. The median of each index was as follows: Pt-VAS 0.7 (IQR 0.2-1.4), LIT 17.5 (IQR 8-35), PGA 0 (IQR 0-1), SLEDAI 2 (IQR 0-4), BILAG 0 (IQR 0-1), SDI 0 (IQR 0-1). While workers (178, 56%) were significantly younger (45 [IQR 33-53] vs 61 [IQR 49-70], p&lt;0.001) and had a shorter disease duration (14 [IQR 6-24] vs. 22 [IQR 9-33], p=0.004) than non-workers, no significant differences in the levels of pt-VAS, LIT, PGA, SLEDAI, BILAG, and SDI were observed between workers and non-workers. Among workers, 27 (15%) had absenteeism and 103 (58%) had presenteeism. Univariable analysis revealed that older age (p=0.049, rho=0.15), higher Pt-VAS (p&lt;0.001, rho=0.41), LIT (p&lt;0.001, rho=0.74), PGA (p=0.008, rho=0.21), BILAG score (p=0.004, rho=0.22), and SDI (p=0.014, rho=0.19) were positively correlated with overall work impairment (absenteeism and presenteeism). Absenteeism showed positive correlations with high levels of LIT (p&lt;0.001, rho=0.38) and PGA (p=0.025, rho=0.18), but not with Pt-VAS, BILAG, and SDI. Presenteeism also showed positive correlations with Pt-VAS (p&lt;0.001, rho=0.44), LIT (p&lt;0.001, rho=0.76), PGA (p=0.021, rho=0.18), BILAG score (p=0.012, rho=0.19), and SDI (p=0.007, rho=0.21). Multivariable analysis revealed that LIT and BILAG independently associated with absenteeism (p&lt;0.001 and p=0.014), presenteeism (p&lt;0.001 and p&lt;0.001), and overall work impairment (p&lt;0.001 and p=0.004), respectively. Receiver operating characteristic (ROC) analysis showed that the cut-off value for LIT to identify absenteeism was 25 (AUC 79%, sensitivity 78%, specificity 71%), and the patients with 25 or higher scores of LIT had a higher frequency of absenteeism (Odds ratio 7.7 [95% CI 2.9–20.4], p&lt;0.001) (Figure 1). On the other hand, the cut-off value for LIT to identify presenteeism was 15 (AUC 86%, sensitivity 75%, specificity 84%), and the patients with 15 or higher scores of LIT had a significantly higher frequency of presenteeism than those without it (Odds ratio 10.9 [95% CI 5.3–22.2], p&lt;0.001). <h3>Conclusion:</h3> Our study suggests that SLE patients tend to have work productivity impairment, which is closely associated with high levels of LIT and BILAG score. <h3>REFERENCES:</h3> [1] Tammy O Utset, Amrutha Baskaran, Barbara M Segal, et al. Work disability, lost productivity and associated risk factors in patients diagnosed with systemic lupus erythematosus. Lupus Sci Med. 2015; 2: e000058. [2] Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics. 1993; 4: 353-365. [3] Jolly M, Garris CP, Mikolaitis RA, et al. Development and validation of the Lupus Impact Tracker: a patient-completed tool for clinical practice to assess and monitor the impact of systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2014; 66: 1542-1550. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>