OBJECTIVES: Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease that often leads to decline in functional status and reduced employability. In this study, factors associated with reduced employment among RA patients were evaluated.

METHODS: Data were drawn from the 2014 Adelphi RA Disease Specific Programme, a cross-sectional survey of rheumatologists and their patients in EU5 (France, Germany, Italy, Spain, UK) and the US. Eligible patients were working age (18-<65 years), excluding patients who retired for non-RA–related reasons. Multivariate logistic regression analyses were performed to examine factors associated with being retired/unemployed due to RA (reported by physicians); included variables covered demographics, region, clinical status, and treatment.

RESULTS: Of 2,247 eligible patients, 122 (5.4%) were retired/unemployed due to RA; the remaining 2,125 were employed/students/homemakers or unemployed for non-RA–related reasons. Among eligible patients, mean (SD) age and time since diagnosis were 46.5 (11.0) years and 4.9 (5.1) years, respectively; 74.6% were female, and 13.6% had a body mass index ≥30 kg/m(obese). In multivariate analyses, increased age (odds ratio [OR]=1.06), obesity (OR=2.74), moderate/severe disease (OR=2.07), and concomitant anxiety/depression (OR=1.63) were significantly associated with an increased risk of RA-related retirement/unemployment, while being Caucasian (OR=0.52) was significantly associated with a lower risk (all P≤0.036). No regional differences (US vs EU) were identified. Among the sub-set of biologic-experienced patients (n=1,423), time between diagnosis and initiation of first biologic was significantly longer among those who were retired/unemployed due to RA than those who were not (4.8 vs 3.6 years, P=0.005). Of 606 patients who completed a self-report form and answered the unemployment-related question, 63 (10%) had changed jobs due to RA.

CONCLUSIONS: Age, obesity, ethnicity, disease severity, and anxiety/depression were associated with risk of RA-related retirement and unemployment. Further study is warranted to determine impact of early biologic initiation on employability among RA patients.