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Patient‐Reported Outcomes Are More Important Than Objective Inflammatory Markers for Sick Leave in Biologics‐Treated Patients With Rheumatoid Arthritis
Author(s) -
Olofsson Tor,
Söderling Jonas K.,
Gülfe Anders,
Kristensen LarsErik,
Wallman Johan K.
Publication year - 2018
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23619
Subject(s) - medicine , sick leave , rheumatoid arthritis , visual analogue scale , erythrocyte sedimentation rate , physical therapy , observational study , arthritis , disease , golimumab , adalimumab
Objective To study the impact of common noncomposite disease activity measures on sick leave in biologics‐treated patients with rheumatoid arthritis (RA). Methods Data from study visits by biologics‐treated RA patients of working age (<65 years) in the observational South Swedish Arthritis Treatment Group Register between 2005 and 2011, were included (5,118 visits by 941 patients). We performed association analyses between various noncomposite disease activity measures at each visit and the number of days of sick leave during the subsequent month; this information was retrieved from the Social Insurance Agency. Adjusted separate generalized estimating equation regression models were used, and analyses were stratified according to sick leave status for the month preceding each visit (no, partial, or full sick leave). Results are presented as standardized beta coefficients for comparability. Results Among modifiable noncomposite disease activity measures, patient's assessment of pain and disease activity scored on a visual analog scale (VAS) were most strongly associated with subsequent sick leave, irrespective of baseline sick leave status. Generally, measures that were more objective (swollen joint count, erythrocyte sedimentation rate, and C‐reactive protein) had less impact on sick leave compared with variables that were more subjective (patient's pain and global scores on a VAS, evaluator's global assessment of disease activity on a 5‐grade Likert scale, and tender joint count). Conclusion Measures of disease activity that are more subjective have a greater impact on sick leave in biologics‐treated patients with RA compared with variables that are more objective, suggesting a stronger focus on subjective measures when targeting work loss or intervening to reduce it.