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The Global Burden of Rheumatoid Arthritis and Forecasted Prevalence to 2050: Estimates from the Global Burden of Disease Study 2021
20 Pages Posted: 1 May 2023
More...Abstract
Background: Rheumatoid Arthritis (RA) is a chronic autoimmune inflammatory disease associated with disability and premature mortality. Up-to-date estimates of RA burden are required for healthcare planning, resource allocation and prevention. This paper provides updated estimates of deaths, prevalence and disability-adjusted life years (DALYs) for RA by age, sex, year, and location, and forecasts prevalence to 2050.
Methods: RA prevalence was estimated in 204 countries from 1990-2020 using DisMod-MR 2.1 based on 98 prevalence and 25 incidence studies. Mortality was estimated from vital registration data with the Cause of Death Ensemble model (CODEm). Years of life lost (YLL) were calculated using standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of RA severity and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed for RA. RA prevalence was forecast to 2050 using logistic regression with socio-demographic index as a covariate and forecasted population estimates.
Findings: Age-standardised global prevalence of RA was 208.8 per 100,000 (95% Uncertainty Interval: 186.8–241.1), representing a 14.1% (12.7–15.4) increase since 1990. Prevalence was higher in females; global age-standardized F:M prevalence ratio 2.45 (2.40-2.47). Global age-standardised RA death rate was 0.47 per 100,000 (0.41–0.54), a -23.8 (29.3–-17.5) percent decline from 1990-2020. The 2020 global age-standardised DALY rate for RA was 36.4 per 100,000 (27.6–45.9), with 76.4% (68.3–81.0) of DALYs due to YLDs. Smoking risk attribution for RA YLDs was 7.2% (3.7–10.3). By 2050, 31.7 million (25.8–39.0) individuals will be living with RA worldwide.
Interpretation: Between 1990-2020 RA mortality decreased globally. Global age-standardised prevalence and YLDs increased over the same period, with prevalence projected to continue to increase to 2050. Improved access to early diagnosis and treatment of RA globally is required to reduce future RA burden.
Funding: Bill and Melinda Gates Foundation, Institute of Bone and Joint Research (IBJR), Global Alliance for Musculoskeletal Health (GMUSC), Commonwealth Govt Australia.
Declaration of Interest: All other authors have nothing to declare.
Keywords: Rheumatoid arthritis, Global Burden of Disease, Burden, Epidemiology
Suggested Citation: Suggested Citation