TY - JOUR T1 - Very Early Intervention Is Crucial to Improve Work Outcome in Patients with Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 1104 LP - 1106 DO - 10.3899/jrheum.090174 VL - 36 IS - 6 AU - KERSTIN EBERHARDT Y1 - 2009/06/01 UR - http://www.jrheum.org/content/36/6/1104.abstract N2 - Work disability is a serious consequence of rheumatoid arthritis (RA).An extensive review concluded that about one-third of patients with RA stopped working within 2 to 3 years after disease onset and that 50% to 60% could be unable to work after 10 to 15 years1. Some recent studies indicate a decline in work disability rates in long-standing RA2,3.Work disability is a great burden for both the individual and society. The patients may experience loss of social role and lower self-esteem and have both reduced income and more expenses. A large part of the arthritis-related societal costs are directly derived from work disability4.Previous studies of work cessation have mainly focused on permanent work disability. Investigations of the sick leave that usually precedes permanent work disability are scarcer. In this issue of The Journal Björk, et al present a report of sick leave 3 years before and 3 years after diagnosis in relation to referents in the Swedish TIRA project5. They report that about half the patients were on sick leave 6 months before diagnosis. The proportion of patients not working did not decrease with time, but after 3 years almost one-third had received disability pension. A disadvantage is that only 120/178 eligible patients took part in the study, although dropouts did not differ regarding demographics and disease state variables at study start. Another limitation of the study is that the registry data obtained from the Swedish social insurance agency did not include sick leave periods shorter than 14 days or for a period even shorter than 28 days. As noted by the authors, the figures obtained for total sick leave are nevertheless mainly in keeping with previous similar studies.Sick leave rates are influenced by the social system and health … Address reprint requests to Dr. Eberhardt. E-mail: kerstin.eberhardt{at}med.lu.se ER -