Achieving comprehensive remission or low disease activity in rheumatoid patients and its impact on workability – Saudi Rheumatoid Arthritis Registry
Received 16 October 2018
Accepted for publication 18 January 2019
Published 17 April 2019 Volume 2019:11 Pages 89—95
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Chuan-Ju Liu
Hani Almoallim,1–3 Nahid Janoudi,2 Fahdah Alokaily,4 Zeyad Alzahrani,5 Shereen Algohary,3 Hanan Alosaimi,3,6 Suzan Attar3,7
1Department of Medicine, Faculty of Medicine, Umm Alqura University, Makkah, Saudi Arabia; 2Department of Medicine, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 3Alzaidi Chair of Research in Rheumatic Diseases, Umm Alqura University, Makkah, Saudi Arabia; 4Division of Rheumatology, Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 5Department of Medicine, Faculty of King Saud bin Abdulaziz for Health Sciences, Jeddah, Saudi Arabia; 6Department of Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia; 7Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Purpose: Ability to work is an important endpoint in rheumatoid arthritis (RA). It is not clear what outcome measures should be used to guide treatment in order to maximize workability. This study addressed the impact of RA on workability in a Saudi population and examined the correlation between objective measures of disease activity and reduced workability. This will allow better understanding of treatment targets that will translate into improved workability.
Patients and methods: Data were collected through a digital patient record keeper: The Rheumatoid Arthritis Saudi Database. Male and female patients, ≥18 years of age, that met the American College for Rheumatology criteria for diagnosis of RA, were recruited, regardless of treatment. Demographic and disease-specific data were collected. Disease Activity Score-28 (DAS-28) was used to define patients as low (DAS-28 ≤3.2) vs high (DAS-28 >3.2) disease activity. Health assessment questionnaire (HAQ) score, visual analog scale (VAS) score, and musculoskeletal ultrasound 7 joint score were documented also. The work productivity and activity impairment (WPAI) score was used to measure absenteeism, presenteeism, overall work impairment, and activity impairment. DAS-28 score was correlated with WPAI score and linear regression used to identify the demographic and measures of treatment response that predict improvement in WPAI score.
Results: Higher absenteeism and more activity impairment were seen for patients with persistent DAS-28 >3.2 (non-achievers). HAQ and VAS scores correlated with presenteeism, overall work impairment, and activity impairment.
Conclusion: Disease activity, as defined by DAS-28 score, correlates with absenteeism and work impairment in a Saudi population. However, on linear regression analysis, HAQ and VAS scores were the only measures predictive of work impairment. These scores should be used to monitor response to treatment regimens that aim to maximize work potential for Saudi individuals.
Keywords: rheumatoid arthritis, work impairment, WPAI score, disease activity, HAQ score, VAS score
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