Clinical Rheumatology

, Volume 37, Issue 5, pp 1413–1416 | Cite as

Impact of early systemic lupus erythematosus on work disability—results from the Finnish nationwide register 2000–2007

  • Pia Elfving
  • Kari Puolakka
  • Vappu Rantalaiho
  • Hannu Kautiainen
  • Lauri J. Virta
  • Oili Kaipiainen-Seppänen
Brief Report


Objectives of this study were to examine work disability (WD) and its leading causes in incident SLE patients. Data were derived from the Finnish nationwide registries to identify all non-retired, 18 to 64-year-old incident SLE patients between 2000 and 2007. Sick benefits and WD pensions and the causes for them were monitored until the end of 2008. A total of 446 working-aged, incident SLE patients available for work force (mean age 42 ± 13 years, 89% females) were found. During the follow-up (median 5.3 years), WD pension was granted to 27 patients. The most common cause was SLE itself (14 patients, 52%), with cumulative incidence of 3.4% (95% CI 1.9 to 5.8) in 5 years and 5.0% (95% CI 3.0 to 8.5) in 8 years, followed by musculoskeletal and psychiatric causes. The age- and sex- adjusted incidence ratio for WD pension in SLE patients due to any cause was 5.4 (95% CI 3.7 to 7.9) compared to the Finnish population. The mean number of WD days was 32 (95% CI 28 to 35) per patient-year among all SLE patients during the follow-up. The study concludes that SLE patients have an increased risk for WD already in early course of the disease.


Insurance benefits Pensions Registries Systemic lupus erythematosus Work disability 



The authors report following financial activities outside the submitted work: PE has received lecture fees from Abbvie and UCB Pharma and reimbursement of congress costs from Roche and Abbvie. KP has received honoraria from Pfizer, Lilly, MSD, Bristol Myers Squibb, UCB Pharma, Novartis, Roche, and Abbvie and reimbursement of congress costs from Roche, Pfizer, and Abbvie. OKS has received reimbursement of training and congress costs from Medac, MSD, Abbvie, Roche, and Pfizer. VR has received grant from Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital, lecture fees from Pfizer, MSD and Bristol Myers Squibb, and reimbursement of training and congress costs from Celegen, Abbvie, Roche, and UCB Pharma.

There was no legal requirement for approval by an ethics committee, since we used only encrypted register data.

Funding information

The study was financially supported by the grants from the Finnish Cultural Foundation, North Savo Regional fund, and the Finnish Rheumatic Disease Research Foundation.


  1. 1.
    Gaubitz (2006) Epidemiology of connective tissue disorders. Rheumatology 45:iii3–iii4CrossRefPubMedGoogle Scholar
  2. 2.
    Huscher D, Merkesdal S, Thiele K, Zeidler H, Schneider M, Zink A, for the German Collaborative Arthritis Centres (2006) Cost of illness in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus in Germany. Ann Rheum Dis 65:1175–1183CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Baker K, Pope J, Fortin P, Silverman E, Peschken C, 1000 Faces of Lupus Investigators, CaNIOS (Canadian Network for Improved Outcomes in SLE) (2009) Work disability in systemic lupus erythematosus is prevalent and associated with socio-demographic and disease related factors. Lupus 18:1281–1288CrossRefPubMedGoogle Scholar
  4. 4.
    Bertoli AM, Fernández M, Alarcón GS, Vilá LM, Reveille JD (2007) Systemic lupus erythematosus in a multiethnic US cohort LUMINA (XLI): factors predictive of self-reported work disability. Ann Rheum Dis 66:12–17CrossRefPubMedGoogle Scholar
  5. 5.
    Boomsma MM, Bilj M, Stegeman CA et al (2002) Patients’ perceptions of the effects of systemic lupus erythematosus on health, function, income, and interpersonal relationships: a comparison with Wegener’s granulomatosis. Arthritis Rheum 47:196–201CrossRefPubMedGoogle Scholar
  6. 6.
    Campbell Jr R, Cooper GS, Gilkeson GS (2009) The impact of systemic lupus erythematosus on employment. J Rheumatol 36:2470–2475CrossRefGoogle Scholar
  7. 7.
    Dhanhani A, Gignac MAM, Su J, Fortin PR (2009) Work disability in systemic lupus erythematosus. Arthritis Rheum 61:378–385CrossRefPubMedGoogle Scholar
  8. 8.
    Ekblom-Kullberg S, Kautiainen H, Alha P, Leirisalo-Repo M, Julkunen H (2015) Education, employment, absenteeism, and work disability in women with systemic lupus erythematosus. Scand J Rheumatol 44:157–162CrossRefPubMedGoogle Scholar
  9. 9.
    Nived O, Andersson M, Lindgren M, Malcus-Johnsson P, Nihlberg A, Nived K, Reimer-Rasmusson G, Sturfelt G, Stahl-Hallengren C, Bengtsson AA (2007) Adherence with advice and prescriptions in SLE is mostly good, but better follow up is needed: a study with a questionnaire. Lupus 16:701–706CrossRefPubMedGoogle Scholar
  10. 10.
    Mok CC, Cheung MY, Ho LY, Yu KL, To CH (2008) Risk and predictors of work disability in Chinese patients with systemic lupus erythematosus. Lupus 17:1103–1107CrossRefPubMedGoogle Scholar
  11. 11.
    Partridge AJ, Karlson EW, Daltroy LH et al (1997) Risk factors for early work disability in systemic lupus erythematosus. Results from a multicenter study. Arthritis Rheum 40:2199–2206CrossRefPubMedGoogle Scholar
  12. 12.
    Sutcliffe N, Clarke AE, Taylor R, Frost C, Isenberg DA (2001) Total costs and predictors of costs in patients with systemic lupus erythematosus. Rheumatology 40:37–47CrossRefPubMedGoogle Scholar
  13. 13.
    Utset TO, Chohan S, Booth SA et al (2008) Correlates of formal work in an urban university systemic lupus erythematosus practice. J Rheumatol 35:1046–1052PubMedGoogle Scholar
  14. 14.
    Utset TO, Baskaran A, Segal BM et al (2015) Work disability, lost productivity and associated risk factors in patients diagnosed with systemic lupus erythematosus. Lupus Sci Med 2:e000058. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yazdany J, Yelin EH, Panopalis P et al (2008) Validation of the systemic lupus erythematosus activity questionnaire in a large obervational cohort. Arthritis Rheum 59:136–143CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Zhu TY, Tam LS, Li EK (2012) Labour and non-labour market productivity in Chinese patients with systemic lupus erythematosus. Rheumatology 51:284–292CrossRefPubMedGoogle Scholar
  17. 17.
    Statistics Finland (2011) Accessed 15 Nov 2011
  18. 18.
    Rantalaiho VM, Kautiainen H, Järvenpää S, Virta L, Pohjolainen T, Korpela M, Möttönen T, Puolakka K (2013) Decline in work disability caused by early rheumatoid arthritis: results from a nationwide Finnish register, 2000-8. Ann Rheum Dis 72:672–677CrossRefPubMedGoogle Scholar
  19. 19.
    Baker K, Pope J (2009) Employment and work disability in systemic lupus erythematosus: a systematic review. Rheumatology 48:281–284CrossRefPubMedGoogle Scholar
  20. 20.
    Zink A, Fischer-Betz R, Thiele K, Listing J, Huscher D, Gromnica-Ihle E, Specker C, Schneider M, German Collaborative Arthritis Centres (2004) Health care and burden of illness in systemic lupus erythematosus compared to rheumatoid arthritis: results from the National Database of the German Collaborative Arthritis Centres. Lupus 13:529–536CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Department of MedicineKuopio University HospitalKuopioFinland
  2. 2.Department of MedicineSouth Karelia Central HospitalLappeenrantaFinland
  3. 3.Department of Internal Medicine, Centre for Rheumatic DiseasesTampere University HospitalTampereFinland
  4. 4.School of MedicineUniversity of TampereTampereFinland
  5. 5.Unit of Primary Health CareHelsinki University Central HospitalHelsinkiFinland
  6. 6.Department of General PracticeUniversity of HelsinkiHelsinkiFinland
  7. 7.Unit of Primary Health CareKuopio University HospitalKuopioFinland
  8. 8.Research DepartmentSocial Insurance InstitutionTurkuFinland

Personalised recommendations