Patient Burden of Rheumatoid Arthritis: Results of a Global Systematic Literature Review on Disability, Work Disruption, and Functional Capability in the Real World

OBJECTIVES: The objective of this review is to synthesize available evidence on the burden of disease in patients with rheumatoid arthritis (RA) with respect to disability, work disruption, and functional capacity. METHODS: Observational studies published between 2006 and 2015 were systematically identified through the MEDLINE, EMBASE and Cochrane databases. Literature were assessed for eligibility by two independent reviewers based on pre-specified criteria. RESULTS: In total, 21 studies met eligibility criteria for inclusion. The studies included patients with RA with varying degrees of disease activity, functional disability, and treatment history, inclusive of both biologic and non-biologic therapies. Substantial levels of absenteeism, presenteeism (ie, working while sick), and early retirement due to disability were consistently reported. Early retirement was reported in up to 85% of patients with severe disability, and up to 80% of patients were reported to receive disability pension. In the US, annual income lost due to reduced productivity was up to $8,957. In Europe, the cost of disability was up to €8,902 - €11,369 annually, up to 96% of which was attributed to early retirement. Multiple regression models revealed work productivity losses to be positively correlated with Health Assessment Questionnaire (HAQ) (P