Patient-Reported Measures Have Greater Effect on Sick Leave in RA

shoulder pain
shoulder pain
Subjective disease activity measures have a greater effect on sick leave in biologic-treated rheumatoid arthritis.

In patients with rheumatoid arthritis (RA) treated with biologics, subjective disease activity measures have a more significant effect on sick leave compared with more objective variables, according to results published in Arthritis Care & Research.

These results suggest that interventions targeting the reduction of work loss in RA should focus more on subjective measures vs objective ones.

The study included participants with RA of working age (<65 years) who were treated with biologics in the observational South Swedish Arthritis Treatment Group Register from 2005 to 2011 (n=941). The researchers looked for an association between noncomposite disease activity measures at each visit and number of sick leave days for 1 month thereafter.

The results indicated that out of modifiable, noncomposite disease activity measures, the visual analogue scale (VAS) global and VAS for pain had the strongest association with subsequent sick leave.

More subjective variables such as VAS global (standardized β=0.14; 95% CI, 0.10-0.19), VAS for pain (β=0.14; 95% CI, 0.09-0.19), Evaluator’s global (β=0.10; 95% CI, 0.06-0.13), and tender joints (β=0.09; 95% CI, 0.03-0.14) had greater effect on sick leave compared with more objective measures such as swollen joints (β=0.05; 95% CI, 0.01-0.10), erythrocyte sedimentation rate (β=0.07; 95% CI, 0.02-0.12), and C-reactive protein (β=0.06; 95% CI, 0.00-0.11).

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“The finding that subjective measures are more closely associated with sick leave than inflammatory markers signals that, at least in a subset of patients, physiotherapy, rehabilitation, or interventions aimed at sensitisation and chronic widespread pain may be more important than increased anti-rheumatic therapy,” the researchers wrote.

Disclosures: Jonas K. Söderling has received consulting fees from AbbVie, Merck, Novartis, Pfizer, and Shire, which was unrelated to the present work. Lars-Erik Kristensen has received speaking fees from AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Roche, Sannofi, Janssen Pharmaceuticals, Merck Sharp & Dohme Corp, Novartis, Pfizer, and UCB Pharma, which was unrelated to the present work. Johan K Wallman has received consulting fees from AbbVie, Celgene, Eli Lilly and Company; Novartis, and UCB Pharma and received a speaking fee from UCB Pharma unrelated to the present work.

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Olofsson T, Soderling JK, Gulfe A, et al. Patient reported outcomes more important than objective inflammatory markers for sick leave in biologics‐treated rheumatoid arthritis patients [published online June 8, 2018]. Arthr Care Res. doi: 10.1002/acr.23619