Gonzalez–Lopez L et al. – In this prospective cohort of Mexican workers with rheumatoid arthritis (RA), the authors identified several factors associated with sick leave episodes and working days lost that should be potentially addressed by a multidisciplinary approach, being required to revaluate these strategies with the aim of increasing the work permanence of these patients.

• A prospective cohort of 123 patients with RA was followed for 1 year.
• Factors evaluated for sick leave episodes included: demographics, job characteristics, comorbidity, depressive symptoms, and clinical/therapeutic variables.
• Rates of sick leave episodes, working days lost, and permanent work disability (PWD) were identified.
• Statistical analysis included Cox regression models estimating hazard risks (HR) and their 95 % confidence intervals (95% CI).

• Cumulative time of follow–up for the cohort was 43,380 days, 24 % of workers had at least one episode of sick leave, with a mean of working days lost per patient–year of 18.36; 4.1 % developed PWD.
• Development of sick leave in the Kaplan–Meier analysis was associated with: age ≥40 years (p = 0.04), having a couple (p = 0.04), performing manual work (p = 0.03), suffering depressive symptoms (p = 0.04), limitations in functioning (p = 0.01), and poor global functional status ≥ III (p = 0.01).
• Cox regression models identified HAQ–Di ≥ 0.6 as the stronger predictor for sick leave (HR = 4.04, 95 % CI 1.41–11.58, p = 0.009) followed by age (HR = 1.05, 95 % CI 1.01–1.11, p = 0.04), ≥4 risk factors had a HR to 9.4 (95 % CI: 2.1–42.7) for sick leave.