Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 2.1 million Americans have RA, most of them women.

Work disability occurs in as much as 6 percent of patients with RA annually; Social Security Disability occurs in nearly two percent annually.

Drugs known as anti-TNF inhibitors are often prescribed to individuals with rheumatoid arthritis, and they work by targeting and blocking the inflammation, and can help reduce pain, morning stiffness, and tender or swollen joints. To determine the effect of anti-TNF therapy on work disability and premature work loss in patients with RA, researchers conducted two studies.

The first study evaluated 8,082 patients with RA, who were employed when diagnosed with RA. Researchers followed participants for up to five and a half years--as long as they remained under the age of 62.

At an average of 12.8 years after the onset of RA, 44 percent of the participants in this study were no longer employed, nearly twenty-three percent considered themselves disabled, and nearly twenty-one percent were receiving SSD.

Researchers determined that anti-TNF therapy was not positively or negatively associated with the risk of work disability. They did, however, find that other factors such as college education (making participants more likely to remain working) and smoking (making participants more likely to experience work disability) had an impact.

During the second study, researchers wanted to determine if anti-TNF therapy can prevent premature work loss after controlling for differences among participants in demographics, disease severity, and work factors.

Participants completed four surveys over three years in this study. All were employed and under the age of 64 at the time of the first survey. Forty-eight percent of the participants were using anti-TNF therapy.

In this study, 231 participants were not working from the time of the second survey on. They were compared with 722 participants who remained employed full time for the duration of the study. Factors associated with premature work cessation included working fewer hours, earning a lower income, and being self-employed - along with older age and more severe disease.

As with work disability measured in the first survey, researchers determined that anti-TNF therapy had little to do with work loss in these patients with RA.

"Work disability is a major cost of rheumatoid arthritis, and it is hoped this cost will be reduced by anti-TNF therapy. However, these studies found no evidence that anti-TNF therapy reduces rheumatoid arthritis work disability," said Saralynn Allaire, ScD; professor of medicine, Boston University School of Medicine; and an investigator in both studies. "It may take longer to see the effects of this therapy on work disability, since it works best when used in the very first stages of disease, or more powerful treatments may be needed."