Background/Purpose: Behcet’s syndrome (BS) is most active during young adulthood and working years, thus affecting productivity. Work disability was previously reported especially among BS patients with eye, vascular and joint involvement. In this study, we aimed to evaluate the work productivity and instability of patients with BS compared to ankylosing spondylitis (AS) patients and healthy controls (HC).

Methods: 125 (103 M/22 F) consecutive BS patients who were routinely followed in our dedicated BS center were studied. Patients with AS (30; 25 M/5 F) who were followed in the rheumatology outpatient clinic of our unit and HC (30; 18 M/12 F) were included as controls. Work Productivity and Activity Impairment Questionnaire (WPAI), Work Productivity Survey (WPS), Work Instability Scale (WIS) were used. Quality of life was assessed with the Behet Disease Quality of Life (BDQoL) scale and disease activity with the Behçet’s Disease Current Activity Index.

Results: The mean age of BS patients was 36±7.8 and the mean disease duration was 8.2±5.6 years (Table). 35 of BS patients with only mucocutaneous, 40 with eye, 28 with vascular and 22 with neurologic involvement were included. Among BS patients 42% reported missing work days (mean 1.8 days/mo), and 48% reported that their productivity was reduced at least by half (mean 4.3 days/mo). The mean WIS score was 12.2 (9.8) in BS patients. 59 BS patients had moderate and 18 BS patients had high work instability. Patients with BS had significantly higher absenteeism (10.0% vs. 1.7%), presenteeism (37.0 % vs. 9.3%), and daily activity impairment (26.4% vs. 8.6%) than HCs (p<0.001) assessed by WPAI. Scores were similar between BS and AS patients. WIS and WPS scores were also similar between BS and AS patients and worse than healthy controls. Work impairment was more pronounced in patients with eye involvement compared to mucocutaneous involvement (p=0.04) and there were no differences between other BS groups. The WPAI presenteeism score was moderately correlated with Behçet Disease Quality of Life scale score (r=-0.57).  Multivariate analysis showed that QoL (OR=0.77, 95% CI=0.66-0.88) and disease activity (OR=1.66, 95% CI=1.01-2.50) were related with WPAI-presenteeism.

Conclusion: Work productivity is impaired in BS patients, especially among those with eye involvement. Work instability is frequent and correlated with disease activity and quality of life.