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. 2023 Nov 14;7:41. doi: 10.1186/s41927-023-00365-4

Table 1.

Characteristics of the individual studies among patients with rheumatoid arthritis

Reference Country Study design Study population Disease duration yr, mean Study period Participation rate (%) Age years (mean) Gender (Female) % Results Employment rate Quality assess-ment
Robinson 1971 [108] Canada Cohort N = 151 male patients with RA admitted to a Rheumatic disease department, n = 94 < 65 yr at follow-up 3.5 yr after discharge n.a 1958–68 62.3 19–64 0

Baseline: 40%

Follow-up: 58%

 6
Meenan 1981 [64] US Cross sectional N = 245 RA patients from 25 rheumatologists from 19 practices;180 working at disease onset

 < 5 yr:42%

 > 5 yr:58%

 n.a n.a (52) 67

Disease onset: 74%;

95% male, 65% female

Time of study: 30.2%

 6
Mäkisara 1982 [63] Finland Cross sectional N = 405 RA patients from one hospital

144 5 yr

131 10 yr

130 15 yr

 1963–78 n.a n.a 66.6

5 yr after onset: 60%

10 yr after onset 50%

15 yr after onset 33%

 5
Pincus 1984 [103] US Cohort N = 75 RA patients followed 9 years 9.8 1973–1982

T1:84.3

T2: 61.8

 27–79 (54.7) 71

Age < 55 in 1973

Onset of disease: 75%

1973: 30.6%; 1982:11%

Age56-64 in 1973

Onset of disease: 84%

1973: 32%;1982: 4%

 5
Kaarela 1987 [98] Finland Cohort N = 103 RA patients; 6–9 yr follow-up 7.7 1973–75 60.2 26–64 62

8 yr after onset: Total 44%

Full-time 36%; part-time 8%

 5
Yelin 1987 [85] US Cross sectional N = 306 RA patients from a cohort of 754 RA patients 11 1985 40.6 (51) 72

Yr of diagnosis: 87%

1985: 51%

 6
Callahan 1992 [39] U.S Cross sectional N = 128 working full-time at disease onset from Vanderbilt and Nashville 10.7 1984–86 n.a 55 41 Full-time 28%; part-time 9.4% 7
Eberhardt 1993, 2007 [92, 93] Sweden Cohort N = 84 RA at baseline; n = 62 followed 2 years  > 2 n.a n.a  > 18 (52.4) 65.5

Baseline: 73.8%

Follow-up: 53.2%

 5
Vlieland 1994 [79] The Netherlands Cross sectional

N = 138 RA

N = 127 at follow-up

5–8 1993 92 20–50 100 43.8% 8
Camilleri 1995 [40] UK Cross sectional N = 162 RA patients using second line drugs n.a n.a 74  < 65 60 30.2% 7
Doeglas 1995 [48] The Netherlands Cross sectional N = 292 RA-patients, n = 119 working at disease onset, duration of disease < 5 yr 1–2 n.a 79.8  < 65 51.3

Baseline: 40.8%

After disease onset:18.5% (45.4% of patients at work at disease onset)

 8
Reisine 1995 [130] US Cohort N = 497 (T1) employed RA; 392 (T2) five yr follow-up 1- > 10 yr 987- 78.9 (48) 72

Baseline employment: 100%

Five yr follow-up: 66%

 6
Allaire 1996 [30] U.S Cross sectional N = 469 from 44 practices of rheumatologists 7 n.a 47.5 18–64 (47) 78 Full-time 50.4%; part-time 8% 9
Fifield 1996 [50] US Cross sectional N = 501 (T1) RA (3-yr follow-up) in work at T1 n.a n.a

n.a. (T1)

74 (T2)

 (47) 70

1 yr of study: 100%

3 yr follow-up: 84%

 7
Mau 1996 [100] Germany Cohort N = 132 (T1) RA patients; follow-up: N = 109 (T2) 7 (T2) 1982–87 82.6 18–60 (49) 73

At follow-up: 47%

Highest decline in employment rate during the first 3 yr.’s of disease

 6
Van Jaarsveld 1998 [77] The Netherlands Cross sectional N = 363 from a cohort of Dutch RA patients 2.8 1990 85.6 19–64 69

RA early patients: 39%

General population: 63%

 8
Albers 1999 [89] The Netherlands Cohort N = 186 early RA patients 3 1991–92 92.1 (53) 61

Female: RA: 23.3%

Dutch population: 30.5%

Male: RA 51.3%

Dutch population: 67.6%

 6
De Roos 1999 [46] US Cross sectional N = 960 from 15 rheumatologists in 11 cities in 6 states 11.2 n.a 67.8 18–64 77.1 Full-time 36.5%; part-time 9.7% 6
Jäntti 1999 [97] Finland Cohort N = 103 RA patients; 83 at 15 yr follow-up; 66 at 20 yr follow-up 8, 15 and 20 1973–1995 n.a n.a 68

1 yr after RA onset: 69%

15 yr after RA onset: 50%

20 yr after RA onset: 20%

 6
Barrett 2000 [90] UK Cohort/ cross sectional/ case–control

Cohort 1: N = 160 RA; N = 110 controls matched for age, sex

Cohort 2: N = 134

 cohort 1: 8.6 cohort 2: 4.1 Employment in 1995 and 1999 45

F:47.8

M:51.6

 71.2

Cohort 1:

1995:52.5%; 1999:36.9%

Cohort 2: 1999 60.4%

1995: RA:54.4%; controls 74.5%

 8
Chorus 2000, 2001, 2003 [13, 42, 43] Netherlands Cross sectional N = 1056, a stratified sample of RA patients from a nationwide standardized diagnosis register of rheumatic diseases 11.9 1994–96 62 15–59 (49) 72 At diagnosis 58.3%; at time of study 35.7% (M:56.7%; F:27.7%) 7
Newhall-Perry 2000 [66] US Cross sectional N = 150 RA patients from a part of the Western Regional Consortium of Practicing Rheumatologists study form 52 practices 0.5 1993–96 n.a 38–62 (51) 80 52% 7
Young 2000 2002 [115, 116] UK Cohort N = 721 RA patients with 5 yr follow-up from rheumatologic clinics in nine districts 0.5 n.a n.a  > 18 65

Baseline: 48%

5 yr follow-up: 29.3%

 6
Reisine 2001 [106] US Cohort N = 497 (T1) employed RA; 260 (T2) nine yr follow-up 1—> 10 1988–97 52.3 n.a 70.6

Baseline employment: 100%

Nine yr follow-up: 42%

 5
Backman 2003 [34] Canada Cross sectional N = 239 RA patients from five rheumatologic departments 12.7 n.a 40 18–65 (50) 81

Total 53.1%

Full-time:30.5%; part-time 13.0%; 8.4% self-employed

 8
Cadena 2003 [38] Colombia Cross sectional N = 79 RA from one outpatient clinic 9 2002 n.a 51.5 88.6 Full-time 22.8, part-time 2.5% 4
Kwon 2003 [57] Korea Cross sectional Total population of RA and with-out RA; N = 17,311 and a subgroup of 133 RA and 5774 non-RA from the Fourth Korea National Health and Nutrition Survey, KNHANES IV n.a 2007–9 n.r

 > 18 (total)

45–64 (subgroup)

Total:

RA 41.7%; non-RA 68.1%

Subgroup:

RA male: 63.2%; female: 35.3%

Non-RA male:83.4%; female 35.2%

 7
Lajas 2003 [129] Spain Cross sectional 201from a retrospective cohort randomly selected from a rheumatology register in Madrid 7.7 1997 58.8 (64.3) 78 62.1% 6
Vlak 2003 [113] Israel Cohort N = 188 RA (95 receiving and 93 not receiving disease modifying antirheumatic drugs, DMARD), RCT with 42 months follow-up 5–8 n.a n.a 58/50 91/81

DMARD:

Baseline: 20.5%; follow-up:8.6%

Non-DMARD:

Baseline:44.3%; follow-up:22.1%

 6
Yelin 2003 [114] US Cohort N = 497 Two cohorts of RA patients (1999); 238 receiving; 259 not receiving etanercept  >  = 3 1999

Cohort 1: 58.9

Cohort 2: 46.7

 18–64 84

Receiving/not receiving etanercept:

At time of diagnosis: 75%/77%

Follow-up: 56%/63%

 6
Dadoniene 2004 [45] The Netherlands Cross sectional N = 238 RA patients from a RA-register in Vilnius 10.4 1998- 58 16–65 (52.2) 86 37% 7
LaCaille 2004 [58] Canada Cross sectional, retrospective 581 RA patients using a province-wide treatment program n.a 1991–98 52 18–65 (47–48) 78–83

Onset of RA 65%

1 yr after onset: 57.5%

2 yr after onset: 55.6%

5 yr after onset: 47%

10 yr after onset: 38%

 7
Poulakka 2004, 2005 [104, 105] Finland Cohort N = 162 RA patients randomly assigned to receive either a combination therapy (n = 82) or single therapy (n = 80) (with or without prednisolone)-five yr follow-up 0.5 1993–95 + 5 yr follow-up 83.1 (45) 62.3

Baseline employment:

Single-drug therapy: 82%

Combination therapy: 89%

5 yr follow-up:

Single-drug therapy: 52.4%

Combination therapy: 68.8%

 6
Allaire 2008 [31] U.S Cohort longitudinal N = 5384 from National Data Bank longitudinal study of RA, diagnosed by rheumatologists n.a 2002- 5 88 18–64 (51.3) 81.9

Disease onset: 84.6%

Currently: Total 58,5%

Full-time 48.3%

 8
Verstappen 2005 [78] The Netherlands Cross sectional N = 296 from 7 outpatient clinics 4.3 1990–98 82 25–65 73

RA patients/general population

Total: 43%; 72.2%

Males: 58.8%; 83.4%

Female: 37.1%/60.7%

 8
Chung 2006 [44] Finland US Cross sectional N = 269 RA-patients from US and N = 364 from Finland, in employment at disease onset 3–4 2001–2 n.a  < 65 (46–47)

U.S:72.5

Finl:70.9

At disease onset:

US:88.5%; Fi:65.4%

At time of study:

US: 1,2,3,4 yr:81.4,78.8, 78.8,77.9%

Fi: 1,2,3,4 yr:60.2, 56.2, 54.9, 52.3%

 7
Nordmark 2006 [102] Sweden Cohort N = 110 RA patients treated by a multidisciplinary team in addition to usual medical treatment 0.5 1995–98 n.a 18–60 75

Baseline: 66.4%; full-time 59.1%; part-time: 7.3%

24 months follow-up: 88.2%; full-time: 67.3%; part-time: 20.9%

 6
Smolen 2006 [109] The Netherlands Cohort N = 856 patients with early RA from an RCT-study of medical treatment follow-up 54 week 0.9 n.a n.a  < 64 (47) 72

Baseline: 64%

Full-time 53%; Part-time 11%

Follow-up (54 w): 67.1%

 6
Eberhardt 2007 [93] Sweden Cohort N = 148 RA at baseline; from one department of rheumatology. After 15 yr N = 63 1 1985–89 80.9

48 (employed)

58 (unemployed)

 64.2

Baseline 72.3%

Follow-up after 15 yr:54%

 5
Reisine 2007 [107] US Cohort n = 48 and n = 91 female RA patients, employed at baseline diagnosed during the last yr selected from two bigger cohorts of RA patients  < 1.5 1987–98 n.a  > 18 100

Baseline: 100%

Follow-up: 71.9%

 5
Verstappen 2007 [112] The Netherlands Cohort N = 148 in working age at start of the study; N = 63 (15 yr follow-up)  < 2 yr at study start 1985–2004 81 18–59 (48/54) 64

Study entry72.3%

After 5 yr: 65%

After 10 yr: 61%

After 15 yr: 54%

 6
Verstappen 2007 [112] The Netherlands Cohort N = 461; 294 in working age 6.4 1999–2000 80  < 65 72

1 yr of follow-up: 33%

2 yr of follow-up: 26.2%

 6
Azevedo 2008 [33] Brazil Cross sectional N = 192 RA patients from one out-patient clinic in Sau Paulo 9.8 Feb-nov 2005 n.a 18–65 (47.4) 86 43.2% 7
Bejano 2008 [91] UK Cohort

N = 115 RA patients

n = 61 Adalimumab + MTX

n = 54 placebo + MTX

 < 2 56-week follow-up 77.7 (47) 56.5

Baseline: 100% employed:

Follow-up:

Adalimumab + MTX: 77%

Placebo + MTX: 46.3%

 6
Han 2008 [121] Austria, Canada, Denmark, France, Germany, Netherlands, Sweden, UK, US RCT N = 1222 patients < 65 yr from two double-blinded, randomized, controlled studies of patients with RA MTX: never or incomplete 81% > 3 yr n.a n.a 20–65 71.9–77.8

Baseline: Never MTX: 66.5%

MTX: Incomplete responders:

Early RA: 61.6%

Long-standing RA: 47.1%

54-week evaluation:

Never MTX: 59.5%

MTX: Incomplete responders:

Early RA: 54.8%

Long-standing RA: 43.0%

 6
Shanahan 2008 [71] Australia Cross sectional N = 497 RA patients from one city 10.7 n.a 60.6 18–65 70

RA patients 51.1%

General population:93%

 7
Zhang 2008 [86] Canada Cross sectional N = 389 RA patients treated with Adalimumab 12 n.a 44 (55) 78 36% 7
Zirkzee 2008 [117] The Netherlands Cohort N = 69 from a cohort of 313 patients with early RA followed for 12 months 0.3 n.a 22 18–64 55

Study entry: 49%

12 months follow-up: 42%

 6
Halpern 2009 [94] US Cohort N = 1233 from a cohort receiving adalimumab or DMARD followed 24 months from Europe, Australia, and Canada 12–13 n.a n.a (54–57) 75.8

Baseline: 27.4%

Follow-up:

12 months: Total:14.5% Adalimumab: 24.1%

DMARD: 8.3%

24 months: Total:11.7% Adalimumab: 22.2%

DMARD: 4.8%

 6
Hoving 2009 [96] The Netherlands Cohort N = 59 RA patients treated with Adalimumab 10.7 2004–6 n.a (49) 76.3

Baseline: 44.1%

6 months follow-up: 35.6%

 5
Osterhaus 2009 [67] Austria, Czech Republic, US) Cross sectional N = 220 randomly selected to a 24-week multicenter RCT study of certolizumab pegol or placebo 9.5 2003–4 n.r 19–62 84 Baseline 38.6% 5
Hazes 2010 [53], Kavanaugh 2009 [56] The Netherlands US Cross sectional N = 982 (RAPID 1); N = 619 (RAPID 2) multicenter, double-blind, placebo-controlled trial of certolizumab Pegol with MTX on work productivity 6 n.a n.a (52) 82–83

Baseline: 38.4%

RAPID 1: Total 41.6%

RAPID 2: Total 39.8%

 5
Herenius 2010 [95] The Netherlands Cohort N = 126 RA patients 6.4 n.a n.a 18–62 (49) 73.8 50% 6
Sokka 2010 [18] Finland Cross sectional 5493 RA patients < 65 yr from a multinational study from 86 sites in 36 countries with self-reported employment status 11 2005–9 n.a  < 65 yr 80

Before RA:

Males: 85% (57–100%)

Females: 64% (19–87%)

After RA:47.2%

 7
Van Vollenhoven 2010 [110] Sweden Cohort N = 664 (baseline) RA patients in a RCT study of MTX (n = 214); Adalimumab + MTX (n = 219); Adalimumab (n = 231); 2-yr multicenter study 0.8 n.a 83 (52) 75 Baseline: Total: 55% 5
Verstappen 2010 [119] The Netherlands Cohort N = 3291 RA patients treated with anti TNF and 379 RA controls: 3 yr follow-up

Anti-TNF:12

Controls 8

 n.a n.a (50–52) 76–77

Anti-TNF: baseline: 37.6%; follow-up 34.2%

Controls: baseline; 46.7%; follow-up 44.3%

 5
Bodur 2011 [37] Turkey Cross sectional N = 49 RA from an outpatient clinic in Ankara 9.7 Within 6 months n.a 46.6 63.3 22.4% 4
Nikiphorou 2012 [101] UK Cohort N = 877 (baseline) from nine outpatients’ clinics; median 10 yr follow-up (N = 591)  < 2 1986–98 67.4  < 60 68

Baseline: 67%

Follow-up: 42.6%

 5
Da Rocha Castelar Pinheiro 2013 [88] Brazil Cross sectional N = 526 RA patients 6.5 2007 n.a 51 80 29% 4
Smolen 2012 [72] The Netherlands Cross sectional N = 520 with available employment data from a cohort with early progressive RA (RCT-study of medical treatments in n = 638) 0.7 n.a 81.5 (52) 73.8 56.9% 6
Mattila 2014 [61] Eleven countries in EU Cross sectional N = 1061; 100 RA patients from each of the countries answered a telephone interview  > 2 n.a n.a (49–57) 74–82

30% (Finland)

57% (Italy)

 5
McWilliams 2014 [99] UK Cohort N = 1235 from The Early RA Network, ERAN inception cohort study from 22 centers in the UK and Ireland 0–10 2002–12 83.8 47–98 (58) 68

Baseline 47%

Follow-up: 10% had lost job

37% employed

 6
Tamborenea 2015 [74] Argentina Cross sectional N = 450 consecutive RA patients from 31 urban rheumatology clinics from 11 provinces  > 0.5 n.a n.a (48–49) 82.6 45.5% 5
Bertin 2016 [36] France Cross sectional N = 488 recruited from 90 rheumatologists in hospital or office practice 12.2 2012–13 n.a  < 60 84.4 74.6% 7
Pieringer 2016 [68] Austria Cross sectional N = 3847 RA patients from 15 countries from four continents (COMORA-study) 9.4 2011–12 n.r (57) 81 31.4% 5
Wan 2016 [81] Singapore Cross sectional N = 108 RA from one rheumatology clinic 7.6 2013–14 87.1 56.4 79.6

Full-time: 29.7%

Part.time:14.8%

 6
Lapcevic 2017 [60] Serbia Cross sectional N = 409 RA patients, multicenter study in 22 health institutions 12 2014 82.8 (58) 87 20.1% 5
Rosa-Gocalves 2018 [69] Portugal Cross sectional N = 154 RA consecutive patients from one hospital 16 2013–14 n.a (56) 87.7 33.8% 5
Van der Zee-Neuen 2017 [76] The Netherlands Cross sectional N = 2395 RA patients < 60 yr from 17 countries from five continents (COMORA-study) n.a n.a n.a 18–60 (48) 84 45% (18.2–70.6%) 7
Vazquez-Villegas 2017 [111] Mexico Cohort N = 614 RA patients 7 1992–2012 n.a  > 18 (42) 83 60.6% 6
Anno 2018 [32] Japan Cross sectional N = 191 RA patients and 191 sex matched without RA (control group) from one university hospital 18.1 2010 n.a  > 20 84.5

RA:

Full-time 18.3%; part-time 16.2%

Controls:

Full-time 17.8%; part-time 21.5%

 8
Berner 2018 [35] Austria Cross sectional 100 seropositive RA from one outpatient clinic 6.5 2015–16 71.4 18–65 (53) 66 59% 8
Chen 2018 [41] Taiwan Cross sectional N = 330 RA from 50 rheumatologists in Taiwan 13.2 n.a n.a 60 74 19.1% among persons in working age 5
Gomes 2018 [51] Brazil Cross sectional N = 133 with RA from a municipality in south Brazil n.a 2014–15 55.1 20–59 82.7 48.8% 8
Fara 2019 [49] Argentina Cross-sectional N = 126 with RA, applicants for disability certificate 10 2012–16 n.a  >  = 16 (55) 79 At application time 36% 6
Xavier 2019 [82]

Argentina

Brazil

Colombia

Mexico

 Cross sectional

N = 290 from 18 rheumatology public and private clinics from

Argentina N = 75; Brazil N = 68; Colombia N = 72; Mexico N = 75

 n.a 2012–15 n.a 21–50 (43.7) 90

Argentina 72.6%

Brazil 44.2%

Colombia 62.5%

Mexico 57.3%

 5
Gwinnutt 2020 [122] UK Cohort N = 463 MTX-starters; N = 260 biologic starters 0.5;5 2008–12 n.a 18–65 68;77

Baseline: 100%

1 yr follow-up: 89%

 4
Intriago 2020 [55] Ecuador Cross sectional N = 395 RA from one clinic 13.8 2019 n.a 51.4 87.8 40.5% 5
Sacilotto 2020 [70] Brazil Cross sectional N = 1115 from a prospective cohort study of RA patients from 11 public health care centers 12.7 n.a n.a  > 18 (56.7) 90 26.8% 5
Syngle 2020 [73] India Cross sectional N = 52 RA patients from an outpatient department 7 2017–18 n.a 29–60 (46) 77 53.8% 6
Zolnierczyk-Zreda 2020 [87] Poland Cross sectional N = 282 RA outpatients from 3 hospitals n.a n.a 100 50.6 80 63.5 8
Al-Jabi 2021 [29] Palestine Cross sectional N = 300 from all rheumatology clinics in a part of Palestine 6 2012 n.a (49) 76.3 26.3% 5
Morf 2021 [65]

Germany

Brazil

 Cross sectional

N = 176 RA from Germany

N = 91 RA from Brazil from two outpatient clinics

Germany 14.4

Brazil 15.9

 2011–12 n.a

Germany 62.4

Brazil 56.3

Germany

78.4

Brazil 92.3

Germany 31.8%

Brazil 35.2%

 5
Tanaka 2021 [75] Japan Cross sectional N = 357 from 82 centers 6.9 2013–17 n.a 58 82.1

Full-time 24.6; Part-time 14.3

Responders:

Full-time 28.3; Part-time 19.1

Non-responders:

Full-time 20.3; Part-time 11.9

 6
Yates 2021 [84] UK Cross sectional N = 7455 RA from 209 secondary rheumatology care units Newly diagnosed 2018–19 n.a 56.7 62.3 48% 4
Dejaco 2022 [47] Austria Cross sectional N = 95 RA baseline; 59 at follow-up multicentre study n.a n.a n.a 54.8 82.1 48.4% 5
Hamdeh 2022 [52] Palestine Cross sectional N = 285, a sample of 1042 RA patients from rheumatology clinics 9.1 2012 n.a 8529 81.1 23.5% 5
Hulander 2022 [54] Sweden Cross sectional N = 50 RA from a RCT study from one outpatient clinic 18.3 2017 84 62.3 81 64% 5
Lahiri 2022 [59] Singapore Cross sectional N = 121 RA from a single center RDCT study 5.5 2016 86 56.6 86.3 46.3% 5
Li 2022 [80] China Cross sectional N = 215 RA from a single out- and inpatient Rheumatology department 10.3 2017–20 69.4 55.4 90.2

Employed 33%

Unemployed30%

Retired 37%

 6
McQuillan 2022 [62] US Cross sectional N = 854 from National Rheumatoid Arthritis Study 10.2 1988–98 n.a 58 78 41% 5
Yajima 2022 [83] Japan Cross sectional N = 165 RA from 4 outpatient clinics 4.5 2013–14 91.2 64 86.1 23% 6

n.a. not analysed, n.r. not relevant, RCT randomized controlled clinical trial, yr year