Table 1 Characteristics of the individual studies among patients with rheumatoid arthritis

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