@article{142aae6723f142da82198296c043e435,
title = "Sick leave in early axial spondyloarthritis: the role of clinical and socioeconomic factors. Five-year data from the DESIR cohort",
abstract = "Objectives To investigate the occurrence of sick leave (SL) and the impact of clinical and socioeconomic factors on SL in early axial spondyloarthritis (axSpA). Methods Patients with a clinical diagnosis of axSpA from the DEvenir des Spondyloarthrites Indifferenciees Recentes (DESIR) cohort with work-related data and up to 5-year follow-up were studied. Incidence, time to first SL and potential role of baseline and time-varying clinical and socioeconomic factors (age, gender, ethnicity, education, job type, marital and parental status) were analysed. Univariable analyses, followed by collinearity and interaction tests, guided subsequent multivariable time-varying Cox survival model building. Results In total, 704 axSpA patients were included (mean (SD) age 33.8 (8.6); 46% men). At baseline, 80% of patients were employed; of these, 5.7% reported being on SL. The incidence of SL among those at risk during the study period (n=620, 88%) was 0.05 (95% CI 0.03 to 0.06) per 1000 days of follow-up. Mean (SD) time to first SL was 806 (595) days (range: 175-2021 days). In multivariable models, male gender (HR 0.41 (95% CI 0.20 to 0.86)) and higher education (HR 0.48 (95% CI 0.24 to 0.95)) were associated with lower hazard of SL, while higher disease activity (HR 1.49 (95% CI 1.04 to 2.13)), older age, smoking and use of tumour necrosis factor inhibitors were associated with higher hazard of SL. Conclusions In this early axSpA cohort of young, working-age individuals, male gender and higher education were independently associated with a lower hazard of SL, whereas older age and higher disease activity were associated with higher hazard of SL. The findings suggest a role of socioeconomic factors in adverse work outcomes, alongside active disease.",
keywords = "epidemiology, inflammation, spondylitis, ankylosing, ANKYLOSING-SPONDYLITIS, WORK PRODUCTIVITY, DISEASE-ACTIVITY, FOLLOW-UP, PRESENTEEISM, CRITERIA, IMPACT, DISABILITY, SOCIETY",
author = "Elena Nikiphorou and Carvalho, {Pedro D.} and Annelies Boonen and Bruno Fautrel and Pascal Richette and Machado, {Pedro M.} and {van der Heijde}, Desiree and Robert Landewe and Sofia Ramiro",
note = "Funding Information: la Recherche Clinique et du D{\'e}veloppement de l{\textquoteright}Assistance Publique—H{\^o}pitaux de Paris. This study is conducted under the umbrella of the French Society of Rheumatology and INSERM (Institut National de la Sant{\'e} et de la Recherche M{\'e}dicale). The database management is performed within the department of epidemiology and biostatistics (Professor Paul Landais, D.I.M., N{\^i}mes, France). An unrestricted grant from Pfizer was allocated for the 10 years of the follow-up of the recruited patients. The authors would like to thank the different regional participating centres: Professor Maxime Dougados (Paris—Cochin B), Professor Andr{\'e} Kahan (Paris—Cochin A), Professor Olivier Meyer (Paris—Bichat), Professor Pierre Bourgeois (Paris—La Piti{\'e} Salpetri{\`e}re), Professor Francis Berenbaum (Paris—Saint Antoine), Professor Pascal Claudepierre (Cr{\'e}teil), Professor Maxime Breban (Boulogne Billancourt), Dr Bernadette Saint-Marcoux (Aulnay-sous-Bois), Professor Philippe Goupille (Tours), Professor Jean-Francis Maillefert (Dijon), Dr Xavier Pu{\'e}chal, Dr Emmanuel Dernis (Le Mans), Professor Daniel Wendling (Besan{\c c}on), Professor Bernard Combe (Montpellier), Professor Liana Euller-Ziegler (Nice), Professor Philippe Orcel, Dr Pascal Richette (Paris—Lariboisi{\`e}re), Professor Pierre Lafforgue (Marseille), Dr Patrick Boumier (Amiens), Professor Jean-Michel Ristori, Professor Martin Soubrier (Clermont-Ferrand), Dr Nadia Mehsen (Bordeaux), Professor Damien Loeuille (Nancy), Professor Ren{\'e}-Marc Flipo (Lille), Professor Alain Saraux (Brest), Professor Corinne Miceli (Le Kremlin Bic{\^e}tre), Professor Alain Cantagrel (Toulouse), Professor Olivier Vittecoq (Rouen). PMM is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the National Institutes of Health (NIH), (UK) National Health Service (NHS), the NIHR or the (UK) Department of Health. Funding Information: Acknowledgements The DESIR cohort was sponsored by the D{\'e}partement de Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.",
year = "2021",
doi = "10.1136/rmdopen-2021-001685",
language = "English",
volume = "7",
journal = "RMD Open",
issn = "2056-5933",
publisher = "BMJ Publishing Group",
number = "2",
}