Psoriatic Arthritis patients with work disability have worse quality of life compared to those who are employed
Flora Farkas, Agnes Szentpetery, Phil Gallagher and Oliver FitzGerald
Department of Rheumatology, St. Vincent’s University Hospital, Dublin, Ireland
Work disability (WD) is an important functional outcome measure in inflammatory arthritis. WD has been studied comprehensively in rheumatoid arthritis and ankylosing spondylitis, however limited data is available in psoriatic arthritis (PsA) 1, 2.
To compare clinical parameters, physical function, quality of life, economic measures and radiographic damage in patients with WD to those who are employed in PsA.
Consecutive patients with PsA fulfilling the CASPAR criteria were enrolled. Two subgroups were created, those with WD and those currently employed. Patients on disability pension, early retirement due to arthritis, those unemployed, away from work for the last 12 months due to sick leave, rehabilitation or hospital admission related to arthritis were considered as having WD. Disease activity measures (TJC, SJC, ESR, CRP, DAS28-ESR/CRP, PASI), medication history, economic data and patients reported measures (HAQ, EQ-5D, SF-36, BASDAI, BASFI, ASQoL, DLQI, PAIN VAS) were compared between the 2 subgroups.
150 patients were recruited of whom 92 filled out the economic questionnaire. 11 were students or natural retirees, leaving 81 patients available for analysis. While there was no significant difference in disease activity measures and the number of erosions between the 2 subgroups, patients with WD were older and had significantly worse self-reported values compared to those who are employed. More patients were on biologic treatment in the employed group, while most of the WD patients were on DMARDs.
Despite similar disease activity and structural damage measures, patients with WD had worse physical function, and overall reduced quality of life compared to employed patients.
1. Tillett, W., C. de-Vries, and N.J. McHugh, Work disability in psoriatic arthritis: a systematic review. Rheumatology, 2012. 51(2): p. 275-283.
2. Boonen A, Severens JL. Rheumatic disease the socioeconomic perspective. ARC Topical Rev 2009;3:112.