7. RA also increases the risk for work disability and therefore impacts livelihood.
The percentage of RA patients who quit working after only a few years of disease is significant and continues incrementally for decades.
According to a 2003 review1 of 14 prospective studies from Finland, Sweden, Germany, Great Britain, and the Netherlands, published from 1987 to 2003, 20% to 30% of RA patients became work disabled during the first 3 years of their disease.
An inception cohort of 103 patients2 with rheumatoid factor (RF)–positive RA, who were studied between 1973 and 1975 as part of the Heinola Follow-up Survey of Arthritis, were examined at onset and at 1, 3, 8, 15, and 20 years after entry. Sixty-six patients attended the 20-year follow-up during 1995–96 (30 had died, and 7 did not participate because of other diseases). The graph shows cumulative retirement due to RA over the 20-year study.
A review3 of 3 principal studies conducted from 1976 to 1984 showed that indirect costs due to lost wages accounted for three fourths of the total cost of RA.
References
1. Sokka T. Work disability in early rheumatoid arthritis. Clin Exp Rheumatol. 2003;21(suppl 31):S71-S Jantti J, Aho K, Kaarela K, Kautiainen H. Work disability in an inception cohort of patients with seropositive rheumatoid arthritis: a 20 year study. Rheumatology (Oxford). 1999;38: Yelin E. The costs of rheumatoid arthritis: absolute, incremental, and marginal estimates. J Rheumatol Suppl. 1996;44:47-51.

13. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med. 2001;344:
Silverman GJ, Carson DA. Roles of B cells in rheumatoid arthritis. Arthritis Res Ther. 2003;5(suppl 4):S1-S6. Smolen JS, Steiner G. Therapeutic strategies for rheumatoid arthritis. Nat Rev Drug Discov. 2003;2:

21. A schematic diagram demonstrating which ligands are neutralized by each of the therapeutics in clinical development