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Hello ! I Think You Remember My Questions From This

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Posted on Wed, 12 Aug 2020
Question: Hello !

I think you remember my questions from this account !
you helped me a lot with positive way of thinking - i hope you could help me now

With now day treatment how much % of rheumatoid arthritis are unemployed ? as i understand from reading they may be unemployed and then when treatment work they will work again - is it so ?

As there are different kind of study

Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/











Mean age of subjects was 52 years, 82% were female, 63% had more than a high school education, mean disease duration was 14 years, and mean Health Assessment Questionnaire score was 1.0. The prevalence of any premature work cessation was 23% in subjects with 1–3 years duration, 35% in those with 10 years, and 51% in those with ≥25 years RA duration. Arthritis-attributed work cessation was 14%, 29%, and 42%, respectively. Annual incidence of any premature work cessation was ~10% and arthritis-attributed work cessation incidence was ~6%. Thirty-nine percent of subjects who stopped working later returned to work

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

To compare disease burden and biologic use among psoriatic arthritis (PsA) or rheumatoid arthritis (RA) patients recruited to the Corrona registry. Retrospective study of patients with PsA or RA enrolled in Corrona between January 2002 and March 2013 and grouped in 2-year intervals. Clinical outcomes and biologic use were assessed. Biologic use increased over time in both cohorts, with 62 and 52% of patients with PsA and RA, respectively, receiving biologics by 2012–2013. However, 25 and 35% of patients with PsA and RA, respectively, continued to experience moderate/high disease activity. Overall, the progressive increase in biologic use accompanied progressive decreases in Clinical Disease Activity Index (from 14.2 to 10.4 for RA, and 12.4 to 8.1 for PsA) and mean Health Assessment Questionnaire score (from 0.36 to 0.34, and 0.3 to 0.24). Mean patient pain, the proportion of patients reporting morning stiffness, and the mean duration of morning stiffness remained similar for both cohorts. PsA and RA treated in the rheumatology setting had a comparable impact on patient quality of life and functional ability. Disease burden improved with increased biologic utilization in both groups; however, moderate/severe disease remains in a significant proportion of PsA and RA patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Thank you very much !
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Follow up: Dr. Divya Agarwal (0 minute later)
Hello !

I think you remember my questions from this account !
you helped me a lot with positive way of thinking - i hope you could help me now

With now day treatment how much % of rheumatoid arthritis are unemployed ? as i understand from reading they may be unemployed and then when treatment work they will work again - is it so ?

As there are different kind of study

Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/











Mean age of subjects was 52 years, 82% were female, 63% had more than a high school education, mean disease duration was 14 years, and mean Health Assessment Questionnaire score was 1.0. The prevalence of any premature work cessation was 23% in subjects with 1–3 years duration, 35% in those with 10 years, and 51% in those with ≥25 years RA duration. Arthritis-attributed work cessation was 14%, 29%, and 42%, respectively. Annual incidence of any premature work cessation was ~10% and arthritis-attributed work cessation incidence was ~6%. Thirty-nine percent of subjects who stopped working later returned to work

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

To compare disease burden and biologic use among psoriatic arthritis (PsA) or rheumatoid arthritis (RA) patients recruited to the Corrona registry. Retrospective study of patients with PsA or RA enrolled in Corrona between January 2002 and March 2013 and grouped in 2-year intervals. Clinical outcomes and biologic use were assessed. Biologic use increased over time in both cohorts, with 62 and 52% of patients with PsA and RA, respectively, receiving biologics by 2012–2013. However, 25 and 35% of patients with PsA and RA, respectively, continued to experience moderate/high disease activity. Overall, the progressive increase in biologic use accompanied progressive decreases in Clinical Disease Activity Index (from 14.2 to 10.4 for RA, and 12.4 to 8.1 for PsA) and mean Health Assessment Questionnaire score (from 0.36 to 0.34, and 0.3 to 0.24). Mean patient pain, the proportion of patients reporting morning stiffness, and the mean duration of morning stiffness remained similar for both cohorts. PsA and RA treated in the rheumatology setting had a comparable impact on patient quality of life and functional ability. Disease burden improved with increased biologic utilization in both groups; however, moderate/severe disease remains in a significant proportion of PsA and RA patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Thank you very much !
doctor
Answered by Dr. Divya Agarwal (7 hours later)
Brief Answer:
Yes, definitely the percentage can be as high as 50

Detailed Answer:
Hello,

Yes, Rheumatoid arthritis leads to unemployment, the disability leads to loss of working hours, as they require to take time off from work, treating these people early leads to freedom from pain and disability and improves this situation.

Yes, as stated in these studies the proportion maybe 10-50%. that is the reason the biologicals we use are expensive... However, the amount they contribute in getting the workforce back to work compensates that expense.

I hope that helps
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
Yes, definitely the percentage can be as high as 50

Detailed Answer:
Hello,

Yes, Rheumatoid arthritis leads to unemployment, the disability leads to loss of working hours, as they require to take time off from work, treating these people early leads to freedom from pain and disability and improves this situation.

Yes, as stated in these studies the proportion maybe 10-50%. that is the reason the biologicals we use are expensive... However, the amount they contribute in getting the workforce back to work compensates that expense.

I hope that helps
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Divya Agarwal (9 hours later)
Thank you for your help ! understanding calm me down

1. But thinking positively if rheumatoid arthritis is treated successful in early stage (biologic drugs) they will get back to work and mathematically these as 40 % or more can get beck to work the unemployed rate is changed from 50 % to down 20 % or less ?

So with effective treatment can unemployed level go down in 10 % or less close to 0 % ? So can now day medication reduce unemployed close to 0% ?



As one article full time job in rheumatoid arthritis was 34 % but they where older with average age 61
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Patients with rheumatoid arthritis (RA) who begin anti-tumor necrosis factor (TNF) therapy within 5 years of disease onset are more likely to regain work ability within 3 years of treatment compared with patients who started the therapy later, according to recent research published in the Annals of the Rheumatic Diseases.

https://www.rheumatologyadvisor.com/home/topics/rheumatoid-arthritis/early-biologic-therapy-for-rheumatoid-arthritis-improves-ability-to-work/

2. Psoriasis arthritis early diagnose and treatment reduce unemployed level?
As it was discuses as it is important early diagnostic and treatment
https://www.celgene.com/reducing-barriers-psoriatic-arthritis-patients/

3. One doctor said that biosimilars drugs now are used but effect could be different with different side effects. But i was reading and it is said that it work the same good and effective - it think it is like that - is it so ?

And you shouldn't notice any difference – your body should respond in the same way to the newer version of the medicine.

Are biosimilars safe?
Biosimilars are thoroughly tested in clinical trials to show they work just as well and are just as safe as the original biological medicine.
https://www.nhs.uk/conditions/biological-and-biosimilar-medicines/

4. Can our day medicine avoid and prevent joint damage completely with effective treatment ?

5. If there is joint damage can surgery effective return you back in normal life with work employ ?

6. rheumatoid arthritis early effective treatment prevent damage of other organs organs such as the lungs, heart, kidney ? As it was discuses in one material !

Than you very much !



default
Follow up: Dr. Divya Agarwal (0 minute later)
Thank you for your help ! understanding calm me down

1. But thinking positively if rheumatoid arthritis is treated successful in early stage (biologic drugs) they will get back to work and mathematically these as 40 % or more can get beck to work the unemployed rate is changed from 50 % to down 20 % or less ?

So with effective treatment can unemployed level go down in 10 % or less close to 0 % ? So can now day medication reduce unemployed close to 0% ?



As one article full time job in rheumatoid arthritis was 34 % but they where older with average age 61
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/


Patients with rheumatoid arthritis (RA) who begin anti-tumor necrosis factor (TNF) therapy within 5 years of disease onset are more likely to regain work ability within 3 years of treatment compared with patients who started the therapy later, according to recent research published in the Annals of the Rheumatic Diseases.

https://www.rheumatologyadvisor.com/home/topics/rheumatoid-arthritis/early-biologic-therapy-for-rheumatoid-arthritis-improves-ability-to-work/

2. Psoriasis arthritis early diagnose and treatment reduce unemployed level?
As it was discuses as it is important early diagnostic and treatment
https://www.celgene.com/reducing-barriers-psoriatic-arthritis-patients/

3. One doctor said that biosimilars drugs now are used but effect could be different with different side effects. But i was reading and it is said that it work the same good and effective - it think it is like that - is it so ?

And you shouldn't notice any difference – your body should respond in the same way to the newer version of the medicine.

Are biosimilars safe?
Biosimilars are thoroughly tested in clinical trials to show they work just as well and are just as safe as the original biological medicine.
https://www.nhs.uk/conditions/biological-and-biosimilar-medicines/

4. Can our day medicine avoid and prevent joint damage completely with effective treatment ?

5. If there is joint damage can surgery effective return you back in normal life with work employ ?

6. rheumatoid arthritis early effective treatment prevent damage of other organs organs such as the lungs, heart, kidney ? As it was discuses in one material !

Than you very much !



doctor
Answered by Dr. Divya Agarwal (1 hour later)
Brief Answer:
SEE BELOW

Detailed Answer:
HI
YES I AGREE IF WE AIM AT COMPLETE REMISSION OF DISEASE AND EARLY TREATMENT DURING WINDOW PERIOD OF EARLY DISEASE WE ARE LOOKING AT VERY LOW UNEMPLOYMENT RATES.
THE TREATMENT MAY BE BIOLOGICAL/CHEMICAL DRUGS.
SO THE AIM SHOULD BE TO HIT THE DISEASE HARD AT AN EARLY STAGE OF DISEASE.
YES I THINK SAME APPLIES TO PSORIATIC ARTHRITIS TOO, DISABILITY AND UNEMPLOYMENT RATES WILL DECREASE.
YES I BELIEVE BIOSIMILARS ARE AS GOOD AS THE INNOVATOR BRANDS AND GIVE GOOD RESULTS.YES THEY ARE QUITE SAFE.

YES EXTRA ARTICULAR DISEASE BURDEN LIKE IN LUNGS CAN ALSO BE REDUCED IMMENSELY
REGARDS

YES MEDICATION IS VERY EFFECTIVE NOW, TO REDUCE DISEASE BURDEN
I WOULD SAY SURGERY CAN BE EFFECTIVE TO SOME EXTENT , LIKE LARGE JOINTS KNEE AND HIP BUT NOT ALL JOONTS LIKE ELBOW AND SHOULDER.


Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Divya Agarwal (0 minute later)
Brief Answer:
SEE BELOW

Detailed Answer:
HI
YES I AGREE IF WE AIM AT COMPLETE REMISSION OF DISEASE AND EARLY TREATMENT DURING WINDOW PERIOD OF EARLY DISEASE WE ARE LOOKING AT VERY LOW UNEMPLOYMENT RATES.
THE TREATMENT MAY BE BIOLOGICAL/CHEMICAL DRUGS.
SO THE AIM SHOULD BE TO HIT THE DISEASE HARD AT AN EARLY STAGE OF DISEASE.
YES I THINK SAME APPLIES TO PSORIATIC ARTHRITIS TOO, DISABILITY AND UNEMPLOYMENT RATES WILL DECREASE.
YES I BELIEVE BIOSIMILARS ARE AS GOOD AS THE INNOVATOR BRANDS AND GIVE GOOD RESULTS.YES THEY ARE QUITE SAFE.

YES EXTRA ARTICULAR DISEASE BURDEN LIKE IN LUNGS CAN ALSO BE REDUCED IMMENSELY
REGARDS

YES MEDICATION IS VERY EFFECTIVE NOW, TO REDUCE DISEASE BURDEN
I WOULD SAY SURGERY CAN BE EFFECTIVE TO SOME EXTENT , LIKE LARGE JOINTS KNEE AND HIP BUT NOT ALL JOONTS LIKE ELBOW AND SHOULDER.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 659 Questions

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Hello ! I Think You Remember My Questions From This

Hello ! I think you remember my questions from this account ! you helped me a lot with positive way of thinking - i hope you could help me now With now day treatment how much % of rheumatoid arthritis are unemployed ? as i understand from reading they may be unemployed and then when treatment work they will work again - is it so ? As there are different kind of study Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/ Mean age of subjects was 52 years, 82% were female, 63% had more than a high school education, mean disease duration was 14 years, and mean Health Assessment Questionnaire score was 1.0. The prevalence of any premature work cessation was 23% in subjects with 1–3 years duration, 35% in those with 10 years, and 51% in those with ≥25 years RA duration. Arthritis-attributed work cessation was 14%, 29%, and 42%, respectively. Annual incidence of any premature work cessation was ~10% and arthritis-attributed work cessation incidence was ~6%. Thirty-nine percent of subjects who stopped working later returned to work https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/ To compare disease burden and biologic use among psoriatic arthritis (PsA) or rheumatoid arthritis (RA) patients recruited to the Corrona registry. Retrospective study of patients with PsA or RA enrolled in Corrona between January 2002 and March 2013 and grouped in 2-year intervals. Clinical outcomes and biologic use were assessed. Biologic use increased over time in both cohorts, with 62 and 52% of patients with PsA and RA, respectively, receiving biologics by 2012–2013. However, 25 and 35% of patients with PsA and RA, respectively, continued to experience moderate/high disease activity. Overall, the progressive increase in biologic use accompanied progressive decreases in Clinical Disease Activity Index (from 14.2 to 10.4 for RA, and 12.4 to 8.1 for PsA) and mean Health Assessment Questionnaire score (from 0.36 to 0.34, and 0.3 to 0.24). Mean patient pain, the proportion of patients reporting morning stiffness, and the mean duration of morning stiffness remained similar for both cohorts. PsA and RA treated in the rheumatology setting had a comparable impact on patient quality of life and functional ability. Disease burden improved with increased biologic utilization in both groups; however, moderate/severe disease remains in a significant proportion of PsA and RA patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/ Thank you very much !