Associations of Work-Related Abilities with Disability in Ankylosing Spondylitis

Kanika Monga¹, MinJae Lee ², Michael Ward ³, Michael Weisman ⁴, Lianne Gensler ⁵, Mariko Ishimori ⁶, Amirali Tahanan ², Mohammad Rahbar ², Matthew Brown ⁷, Logan Oliver ¹, Soudabeh Daliri ¹, John Reveille ⁸ and Mark Hwang ², ¹University of Houston-McGovern Medical School, HOUSTON, TX, ²University of Texas-McGovern Medical School, Houston, TX, ³NIAMS, Bethesda, MD, ⁴David Geffen School of Medicine at UCLA, Los Angeles, CA, ⁵University San Francisco California, San Francisco, CA, ⁶Cedars-Sinai Medical Center, Los Angeles, CA, ⁷Queensland University of Technology, Queensland, Australia, ⁸University of Texas McGovern Medical School, Houston

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Ankylosing spondylitis (AS)

Session Information

Date: Sunday, November 10, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster I: Axial Spondyloarthritis, Clinical Features

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Withdrawal from the workforce is 3.1 times higher in patients with Ankylosing Spondylitis (AS) compared to the general population [Boonen A, et al. 2001]. Functional disability is the most important predictor of total costs in patients with AS [Ward M. 2002]. Age at onset of AS, less formal education, and having physically demanding jobs were significant risk factors for permanent work disability, which had a prevalence of 13% in one AS cohort [Ward M, et al. 2001].

The purpose of our study was to identify factors associated with work disability, including specific work abilities, in patients with AS. We chose to specifically look at trunk strength, and dynamic flexibility because prior research has shown that bending, twisting, and stretching are the occupational activities associated with greater functional limitations and radiographic damage in patients with longstanding AS [Ward M, et al. 2008].

Methods: We included 1115 patients meeting modified New York Criteria from a prospective AS cohort. We used patients’ current occupation data reported. Occupations were assigned a code from the Occupational Information Network, the US Department of Labor’s job classification database. Each code is associated with a scale ranging from 0-100 that signifies the degree of importance of a particular work ability for that occupation. We used univariable and multivariable logistic regression models to evaluate whether work-related ability that requires trunk strength or dynamic flexibility was associated with self-reported disability.

Results: Our cohort had a mean ± SD age of 45 years, 73.9% were male, 81.0 % were white, and 18.7% reported work disability secondary to AS. In the multivariable model, after controlling for confounders such as demographic characteristics, work activity that required more trunk strength was significantly associated with disability (adjusted OR (aOR) 1.02; 95% CI,1.004-1.03), but no significant association was found between dynamic flexibility and disability (aOR 0.99; 95% CI,0.95-1.02). Older age was also significantly associated with disability (aOR 1.03). Higher education and White race were inversely associated with disability (aOR 0.82 and aOR 0.50, respectively). We did not find any significant effect modification between each variable and trunk strength or dynamic flexibility.

Conclusion: AS patients with occupations requiring higher trunk strength reported significantly higher work disability. Another association included older age. Longer years of education and White race were inversely associated with disability. Disease onset of AS begins when patients are usually in young adulthood; identifying risk factors may identify potential interventions that decrease work disability for AS patients.

Disclosure: K. Monga, None; M. Lee, None; M. Ward, None; M. Weisman, AbbVie, 9, Boehringer Ingelheim, 9, Eli Lilly, 5, Lilly, 5, 9, Novartis, 5, Paul Hastings, 9, SetPoint Medical, 9, Takeda, 9, Tharpe & Howell LLP, 9, UCB, 5; L. Gensler, AbbVie, 2, 5, Abbvie, 2, 9, Amgen, 2, Amgen, AbbVie and Novartis, 2, Center for Disease Control, 8, Division of Vaccine Injury Compensation, 8, Eli Lilly, 5, 9, Eli Lilly and Company, 9, Galapagos, 5, 9, Galapagos, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, 5, Janssen, 5, 9, Novartis, 2, 5, 9, Pfizer, 2, 9, Spondylitis Association of America, 6, Spondyloarthritis Research and Treatment Network (SPARTAN), 6, UCB, 2, 5, 9, UCB Pharma, 2, 9; M. Ishimori, None; A. Tahanan, None; M. Rahbar, None; M. Brown, None; L. Oliver, None; S. Daliri, None; J. Reveille, Abbvie, 2, CB, 5, Eli Lilly, 2, 5, 8, Janssen, 2, Janssen Research & Development, LLC, 2, Novartis, 5, Pfizer, 2, 5, UCB, 5; M. Hwang, Eli Lilly, 2.

To cite this abstract in AMA style:

Monga K, Lee M, Ward M, Weisman M, Gensler L, Ishimori M, Tahanan A, Rahbar M, Brown M, Oliver L, Daliri S, Reveille J, Hwang M. Associations of Work-Related Abilities with Disability in Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/associations-of-work-related-abilities-with-disability-in-ankylosing-spondylitis/. Accessed .

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