Prompt Treatment of Rheumatoid Arthritis Decreases Work Disability

For Release at 5:30 PM CT, Friday Oct. 25, 2002

Initial aggressive drug treatment may prevent work disability in patients with early stage rheumatoid arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in New Orleans, Louisiana.

Work disability can be an expensive consequence of rheumatoid arthritis, which translates into less income for the patient and less productivity for society. Previous studies have shown that aggressive initial drug therapy with a combination of antirheumatic drugs, such as methotrexate and sulfasalazine, compared to therapy with a single antirheumatic drug in early rheumatoid arthritis leads to slower progression of joint damage over the first two years.

This study analyzes the impact of single drug versus combination drug therapy treatment strategies on patients' working ability. At the beginning of the study, 162 patients were working or were employable. Of them, 80 received the combination therapy and 82 a single antirheumatic drug for two years. After that time, all patients could be treated with a combination of drugs. After five years, researchers obtained data of the patients' sick leave and arthritis-related retirement by utilizing the national social insurance registers and case records.

Work disability lasted far longer in the single-drug group than in the combination-drug group: median was 32 days versus 12 days per patient-year. Work disability benefits from the Finnish social insurance system were 897 Euro versus only 305 Euro (median per patient-year), respectively. (1 Euro is about $1.) Lost income, however, represents only a portion of lost work productivity each year.

"Early aggressive therapy with a combination of antirheumatic drugs in recent-onset rheumatoid arthritis maintains the patients' earning capacity better than single-drug therapy and saves substantially the costs to society," said Kari Puolakka, MD, Chief of Department, Lappeenranta Central Hospital in Finland, and an investigator in the study.

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see www.rheumatology.org.