Does disease activity at start of biologic therapy influence work-loss in RA patients?

Tor Olofsson, Kari Johansson, Jonas K Eriksson, Ronald van Vollenhoven, Heather Miller, Ingemar F. Petersson, Johan Askling, Martin Neovius

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVE: To compare work-loss in RA patients starting their first biologic with high vs moderate disease activity.

METHODS: We identified all RA patients aged 20-63 years in the Swedish Biologics Register who started their first biologic 2007-09 with high disease activity (DAS28 >5.1; n = 868) or moderate disease activity (DAS28 3.2-5.1; n = 854). Work days lost, defined as sick leave and disability pension days from the Swedish Social Insurance Agency, were assessed over 5 years after first bio-start. We estimated between-group mean differences adjusted for age, sex, calendar year, education level, disease duration, comorbidities and work-loss the month before bio-start.

RESULTS: During 5 years after anti-TNF start, mean monthly work days lost declined from 16.0 to 9.2 (42%; P < 0.001) in patients with high disease activity at baseline and from 12.0 to 7.2 (40%; P < 0.001) in patients with moderate disease activity, with no between-group difference (adjusted mean difference 0.81; 95% CI - 0.44, 2.05). Accumulated 5-year work-loss was, however, higher in the high activity group (724 vs 548 days; adjusted mean difference 70; 95% CI 20, 120), but after stratification on baseline disability pension status, no differences in accumulated work-loss were detected.

CONCLUSION: Substantial work-loss was seen in both patients with high and patients with moderate disease activity at anti-TNF start, with a 5-year decline in mean monthly work days lost by ∼40% in both groups and no between-group difference. Accumulated work-loss over 5 years was higher in the high-activity group, which may be explained by differences in baseline disability pension status.

Original languageEnglish
Pages (from-to)729-34
Number of pages6
Issue number4
Publication statusPublished - Apr 2016

Cite this

Olofsson, T., Johansson, K., Eriksson, J. K., van Vollenhoven, R., Miller, H., Petersson, I. F., ... Neovius, M. (2016). Does disease activity at start of biologic therapy influence work-loss in RA patients? Rheumatology, 55(4), 729-34.