Organ Manifestations and Disease Activity Increase Work Loss in Patients With Lupus

In persons with systemic lupus erythematosus (SLE), incident thrombotic events are associated with a somewhat high risk of acute work loss and musculoskeletal manifestations and neuropsychiatric events with more delayed work loss. Increases in disease activity are prospectively associated with work loss.

Yelin and associates used the University of California, San Francisco, Lupus Outcomes Study, a longitudinal cohort of 1204 persons with SLE, to estimate the time from incident-specific organ manifestations and increases in disease activity until work loss. The principal data collection was an annual structured telephone interview.

For patients with thrombotic events or increased disease activity, there was a marked drop in employment in the first 12 months and a continuing steep decline in employment for at least 4 years, ending with employment rates near 40%. Patients with incident neuropsychiatric or musculoskeletal manifestations had less steep immediate declines in employment, although only about half were still employed after 4 years. Older age, shorter job tenure, and greater number of manifestations increased the risk of work loss.