Online first

Acta Reumatológica Portuguesa - Online First: 2020-08-25
Original article

Early Retirement Attributed to Rheumatoid Arthritis and Its Predictors

Luís M, Garcia S, Guimarães F, António M, Fernandes A, Araújo F, Cunhs R, Couto M, Pinto A, Silva L, Cruz M, Santos M, Silva J, Duarte C


Objective: To evaluate the rate of early retirement due to rheumatoid arthritis (RA) in Portugal. Methods: Prospective cohort study involving 11 Portuguese centers, including patients with a clinical diagnosis of RA, based on registry, enrolled between 2008 and 2019. Results: 3231 patients were included (81.5% female, aged 60.8 ± 13.0 years, mean disease duration 18.0 ± 10.3 years). Until the present time, 37.6% of these patients retired, 59.6% due to RA. Early retirement due to RA translated into losing 7 years of active work when compared to patients retired to other causes. Compared to professionally active patients, retired patients due to RA were diagnosed later in the disease process (p=0.003), had longer disease duration (p < 0.001), were more frequently positive for rheumatoid factor (p=0.043), had more frequently erosive disease (p < 0.001), had a blue-collar occupation (p < 0.001) and had a lower educational level (p < 0.001). Independent predictors for early retirement due to RA were: delayed diagnosis (OR: 2.23; 95% CI 1.18-4.21/year, p=0.013), erosive disease (OR: 2.21 95% CI 1.54-3.16, p < 0.001), need for biologic therapy (OR: 1.32; 95%CI 1.01-1.73, p=0.045) and lower educational level (OR: 0.83; 95%CI 0.79-0.86/year, p < 0.001). Conclusion: RA is, itself, the leading cause of early retirement in RA patients, accounting for the loss of an average of 7 years of active work. Delayed diagnosis, erosive disease and lower educational level are the main predictors of early retirement associated with RA in this population.