Background/Purpose: Psoriatic arthritis (PsA) can lead to pain, disability and a loss of quality of life [Rosen, Rheumatology 2012]. PsA can also lead to impairments in work and social activities, increasing societal costs. The magnitude and determinants of these impairments in Dutch PsA patients is insufficiently researched.

Methods: This cross-sectional study used sociodemographic and clinical data collected from the electronic patient files of PsA patients treated at the department of rheumatology of the Sint Maartenskliniek, Netherlands. All patients were treated according to Psoriatic Arthritis Disease Activity Score (PASDAS) driven treat-to-target, as described previously [Mulder, Rheumatology 2020]. Data about work and activity impairment were collected via the Work Productivity and Activity Impairment (WPAI) questionnaire. To compare our PsA-cohort with the Dutch general population (GP), we used age- and sex-matched data derived from the Central Bureau of Statistics. Regression analyses were performed to examine determinants of impairment.

Results: 246 patients were included in this study, of which 125 (48.8%) were male. Mean age was 55.7 years (SD=13.2). Over half of the patients had a paid job (work-for-pay, WFP, 53%). Compared to the age-and sex-matched Dutch GP, less patients with PsA had a paid job (Dutch GP 63% vs. PsA cohort 53%, p < 0.001). A lower age and a better physical function (Health Assessment Questionnaire-Disability Index (HAQ-DI)) were associated with WFP-status. Overall work impairment of those with a paid job was 10% (interquartile range, 10-40%). In this subgroup, higher disease activity score (PASDAS), worse physical function (HAQ-DI) and worse mental health-related quality of life (Mental Component Summary score – MCS-12) were associated with more work impairment (p< =0.05). Notably, age, sex and treatment modality were not associated with work impairment.

Conclusion: Our study indicates that Dutch patients with PsA were less likely to have a paid job compared to the Dutch general population. When working, they suffered an average productivity loss of 10%. Physical function seems to be a shared factor in the risk for work impairment as well as the risk for not having a paid job. Lower disease activity as measured by PASDAS seems to protect against work impairment, regardless of treatment modality. We suggest that by maintaining adequate disease control, patients can be protected from work impairment and future inability to work or loss of job.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/participation-in-psoriatic-arthritis-part2-a-cross-sectional-study-of-work-impairment-in-psoriatic-arthritis-patients-in-the-netherlands/