AB1193 WORK INSTABILITY AMONG POLISH RHEUMATOID ARTHRITIS PATIENTS

Abstract

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 correlationResults: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<0.001), HAQ-DI>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<0.001). Correlations were moderate between RA-WIS and VASp (RS=0.59, p<0.001) and HAQ-DI (RS=0.52, p<0.001) whereas weak with disease activity indices (DAS28 - RS=0.31, p<0.001; DAS28-CRP - RS=0.28, p<0.001).Table 1.Demographic and clinical characteristics of employed patients according to work instability risk, N(%) or mean(±SD).CharacteristicRA-WIS scorelow-to-moderate (0-17)high (>17)Patients94 (67.1%)46 (32.9%)Sex, female73 (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, positive68 (72.3%)34 (73.9%)ACPA, positive59 (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)*TJC4.5 (±4.0)7.6(±6.3)*SJC2.7 (±3.0)5.2(±5.5)*HAQ-DI0.7 (±0.5)1.1 (±0.5)*pain - VAS 10 cm3.9 (±1.9)6.5 (± 2.2)*DAS283.5 (±1.2)4.2 (±1.4)*DAS28-CRP3.9 (±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<0.05, Mann-Whitney U testConclusion:Pain and disability are main factors associated with work instability among patients with RA.