OBJECTIVES: The objective of this review is to synthesize available evidence on the burden of disease in patients with rheumatoid arthritis (RA) with respect to disability, work disruption, and functional capacity.

METHODS: Observational studies published between 2006 and 2015 were systematically identified through the MEDLINE, EMBASE and Cochrane databases. Literature were assessed for eligibility by two independent reviewers based on pre-specified criteria.

RESULTS: In total, 21 studies met eligibility criteria for inclusion. The studies included patients with RA with varying degrees of disease activity, functional disability, and treatment history, inclusive of both biologic and non-biologic therapies. Substantial levels of absenteeism, presenteeism (ie, working while sick), and early retirement due to disability were consistently reported. Early retirement was reported in up to 85% of patients with severe disability, and up to 80% of patients were reported to receive disability pension. In the US, annual income lost due to reduced productivity was up to $8,957. In Europe, the cost of disability was up to €8,902 - €11,369 annually, up to 96% of which was attributed to early retirement. Multiple regression models revealed work productivity losses to be positively correlated with Health Assessment Questionnaire (HAQ) (P<0.001) and negatively correlated with age (P<0.001) and disease duration (P<0.05). Patients with high HAQ scores (2.1-3) have been reported to have productivity losses up to 5 times higher than those with scores between 0.0-0.5. Studies suggest a positive impact of biologics on productivity losses, especially in patients with more severe disability.

CONCLUSIONS: Our study provides a comprehensive review and synthesis of available published studies reporting the impact of RA and its characteristics on productivity losses. Despite improvements over time with the increased availability of biologic therapies, patients still experience relatively high levels of early retirement and disability, suggesting a need for additional RA therapies.