Background/Purpose:

Despite recent advances in the treatment of systemic vasculitis (SV), direct consequences of the disease leading to impairments in physical and mental function can cause disability, which is an understudied aspect of SV.  The objective of this research was to assess work limitations and disability in patients with SV. 

Methods:

Patients aged >18 years old with SV (anti-neutrophilic cytoplasmic antibody-associated vasculitis (AAV), polyarteritis nodosa, large vessel vasculitis, IgA vasculitis, Behcet’s syndrome or cryoglobulinemic vasculitis) were recruited from a tertiary care Rheumatology clinic (London, Canada). Work disabled (WD) was defined as not working, early retirement, or reduced hours at work due to SV. Participants who were working at the time of enrolment completed the Work Limitations Questionnaire (WLQ). Other work-related measures were self-reported by questionnaire. At the time of enrolment, the Vasculitis Damage Index (VDI) was also obtained.

Results: 103 participants completed the study (mean age 58±17, 60% females, 48% with AAV, 26% LVV and 26% other). 52 (51%) subjects were WD or retired for reasons other than SV and were excluded from further analyses; 22 (21%) were WD secondary to SV and 29 (28%) did not report any disability. SV-related WD subjects were more likely to have a diagnosis of AAV and a lower level of education (p<0.01) than non-WD subjects. Mean VDI scores were higher in SV-related WD vs. non-WD subjects (1.9±2.7 vs. 2.9±1.4; p=0.015).  Involvement of musculoskeletal, peripheral vascular, ocular and neuropsychiatric systems was more common in WD. 38 subjects were working and completed the WLQ; their productivity loss was 8.9±7.2%, higher than control patients from the same center with Rheumatoid Arthritis and Ankylosing Spondylitis (4.5% and 5.8%, respectively). 

Conclusion: SV-related work disability occurred in 21% of patients and was associated with a diagnosis of AAV, lower levels of education, higher disease activity and damage scores.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/work-limitations-and-disability-in-patients-with-systemic-vasculitis/