Scleroderma Study Identifies Roadblocks To Employment PDF Print E-mail
Wednesday, 22 June 2011 09:48
In the United States, the work disability rate for people with systemic scleroderma, also known as systemic sclerosis, is two to three times that of people with some other rheumatic conditions, according to research data from investigators at The University of Texas Health Science Center at Houston (UTHealth) Medical School. To help people with systemic scleroderma obtain or hold onto jobs, researchers investigated determinants of work disability in one of the largest longitudinal cohorts of systemic scleroderma patients in the country – the Genetics versus Environment in Scleroderma Outcome Study (GENISOS).

Researchers found that demographic, clinical and psychosocial factors contribute to systemic scleroderma-related work disability, said Shervin Assassi, M.D., M.S., the study’s senior author and an assistant professor of medicine at the UTHealth Medical School. Findings are online and are scheduled to be in the August print issue of Seminars in Arthritis and Rheumatism.

Lower educational level, more severe fatigue and lung involvement (thickening in the lung tissue and vessels), as well as less social support, were associated with work disability in the early stages of the disease. In patients who were working when they entered the GENISOS study, non-Caucasians in addition to those with more severe fatigue and lung involvement were at higher risk of developing a work disability due to their health.

Identifying factors linked to work disability in people with systemic scleroderma from left to right are Roozbeh Sharif, M.D., Maureen Mayes, M.D., M.P.H., and Shervin Assassi, M.D., M.S.

The silver lining of the study is that progress is being made in addressing at least one of the medical factors and actions can be taken to address two of the non-medical factors in some circumstances.

“Severity of lung involvement is the most prominent clinical factor that predicts work disability among patients with scleroderma,” he said. “We are presently investigating clinical, genetic and other biological markers that can predict the course of scleroderma lung disease.”

Maureen Mayes, M.D., M.P.H., a study co-author, professor and Elizabeth Bidgood Chair in Rheumatology  at the UTHealth Medical School, said the study suggests that retraining may be an option for people no longer able to perform their current duties. Further, additional support may help people keep or get a job, said Roozbeh Sharif, M.D., lead author and a postdoctoral fellow at the UTHealth Medical School.

“Patients who had a better interpersonal support system from their family members and friends had a lower chance of developing work disability,” he said. “These findings further emphasize the important impact of psychosocial factors on the scleroderma patient and underscore the beneficial role of strong social support from family, friends and patient support groups.”

The work disability study was based on an analysis of 284 people in the GENISOS cohort. About 44 percent had a work disability when they enrolled. After approximately 4.5 years of follow-up, the work disability rate rose to 62 percent. The ongoing study is conducted at UTHealth, The University of Texas Health Science Center San Antonio and the University of Texas Medical Branch at Galveston (UTMB).

UTHealth Medical School contributors include: John D. Reveille, M.D., professor, George S. Bruce, Jr. Professorship in Arthritis and Other Rheumatic Diseases and Linda and Ronny Finger Foundation Distinguished Chair in Neuroimmunologic Disorders; Rosa M. Estrada-Y-Martin, M.D., associate professor of medicine;  Frank C. Arnett, M.D., former professor of medicine; and Deepthi K. Nair, scientific programmer. Alison Brown is the coordinator of GENISOS at UTHealth.

Other collaborators include: Perry M. Nicassio, Ph.D., University of California, Los Angeles; Emilio B. Gonzalez, M.D., and Terry A. McNearney, M.D., both at UTMB; and Hilda Draeger, M.D., UT Health Science Center San Antonio.

The study titled “Determinants of Work Disability in Patients with Systemic Sclerosis: A Longitudinal Study of the GENISOS Cohort” received support from the National Institutes of Health (NIH)  Center of Research Translation, University Clinic Research Center, an NIH Clinical and Translational Sciences Award and the National Center for Research Resources.

Cahill, R. (2011), "Scleroderma Study Identifies Roadblocks To Employment", Health Canal; full and original article can be viewed here.

 
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