Abstract
Background: Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050. Methods: Rheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (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 with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Findings: In 2020, an estimated 17·6 million (95% uncertainty interval 15·8–20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8–241·1) per 100 000 population, representing a 14·1% (12·7–15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40–2·47]). The age-standardised death rate was 0·47 (0·41–0·54) per 100 000 population (38 300 global deaths [33 500–44 000]), a 23·8% (17·5–29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000–3 860 000), with an age-standardised DALY rate of 36·4 (27·6–45·9) per 100 000 population. YLDs accounted for 76·4% (68·3–81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6–10·3). We forecast that 31·7 million (25·8–39·0) individuals will be living with rheumatoid arthritis worldwide by 2050. Interpretation: Rheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease. Funding: Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
Original language | English |
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Pages (from-to) | e594-e610 |
Number of pages | 17 |
Journal | The Lancet Rheumatology |
Volume | 5 |
Issue number | 10 |
DOIs | |
Publication status | Published - Oct 2023 |
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In: The Lancet Rheumatology, Vol. 5, No. 10, 10.2023, p. e594-e610.
Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Global, regional, and national burden of rheumatoid arthritis, 1990–2020, and projections to 2050
T2 - a systematic analysis of the Global Burden of Disease Study 2021
AU - Black, Rachel J.
AU - Cross, Marita
AU - Haile, Lydia M.
AU - Culbreth, Garland T.
AU - Steinmetz, Jaimie D.
AU - Hagins, Hailey
AU - Kopec, Jacek A.
AU - Brooks, Peter M.
AU - Woolf, Anthony D.
AU - Ong, Kanyin Liane
AU - Kopansky-Giles, Deborah R.
AU - Dreinhoefer, Karsten E.
AU - Betteridge, Neil
AU - Aali, Amirali
AU - Abbasifard, Mitra
AU - Abbasi-Kangevari, Mohsen
AU - Abdurehman, Ame Mehadi
AU - Abedi, Aidin
AU - Abidi, Hassan
AU - Aboagye, Richard Gyan
AU - Abolhassani, Hassan
AU - Abu-Gharbieh, Eman
AU - Abu-Zaid, Ahmed
AU - Adamu, Kidist
AU - Addo, Isaac Yeboah
AU - Adesina, Miracle Ayomikun
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Afzal, Muhammad Sohail
AU - Ahmed, Ayman
AU - Aithala, Janardhana P.
AU - Akhlaghdoust, Meisam
AU - Alemayehu, Astawus
AU - Alvand, Saba
AU - Alvis-Zakzuk, Nelson J.
AU - Amu, Hubert
AU - Antony, Benny
AU - Arabloo, Jalal
AU - Aravkin, Aleksandr Y.
AU - Arulappan, Judie
AU - Ashraf, Tahira
AU - Athari, Seyyed Shamsadin
AU - Azadnajafabad, Sina
AU - Badawi, Alaa
AU - Baghcheghi, Nayereh
AU - Baig, Atif Amin
AU - Balta, Asaminew Birhanu
AU - Banach, Maciej
AU - Banik, Palash Chandra
AU - Barrow, Amadou
AU - Bashiri, Azadeh
AU - Bearne, Lindsay M.
AU - Bekele, Alehegn
AU - Bensenor, Isabela M.
AU - Berhie, Alemshet Yirga
AU - Bhagavathula, Akshaya Srikanth
AU - Bhardwaj, Pankaj
AU - Bhat, Ajay Nagesh
AU - Bhojaraja, Vijayalakshmi S.
AU - Bitaraf, Saeid
AU - Bodicha, Belay Boda Abule
AU - Botelho, João Silva
AU - Briggs, Andrew M.
AU - Buchbinder, Rachelle
AU - Castañeda-Orjuela, Carlos A.
AU - Charalampous, Periklis
AU - Chattu, Vijay Kumar
AU - Coberly, Kaleb
AU - Cruz-Martins, Natália
AU - Dadras, Omid
AU - Dai, Xiaochen
AU - de Luca, Katie
AU - Dessalegn, Fikadu Nugusu
AU - Dessie, Gashaw
AU - Dhimal, Meghnath
AU - Digesa, Lankamo Ena
AU - Diress, Mengistie
AU - Doku, Paul Narh
AU - Edinur, Hisham Atan
AU - Ekholuenetale, Michael
AU - Elhadi, Muhammed
AU - El-Sherbiny, Yasser Mohamed
AU - Etaee, Farshid
AU - Ezzeddini, Rana
AU - Faghani, Shahriar
AU - Filip, Irina
AU - Fischer, Florian
AU - Fukumoto, Takeshi
AU - Ganesan, Balasankar
AU - Gebremichael, Mathewos Alemu
AU - Gerema, Urge
AU - Getachew, Motuma Erena
AU - Ghashghaee, Ahmad
AU - Gill, Tiffany K.
AU - Gupta, Bhawna
AU - Gupta, Sapna
AU - Gupta, Veer Bala
AU - Gupta, Vivek Kumar
AU - Halwani, Rabih
AU - Hannan, Md Abdul
AU - Haque, Shafiul
AU - Harlianto, Netanja I.
AU - Harorani, Mehdi
AU - Hasaballah, Ahmed I.
AU - Hassen, Mohammed Bheser
AU - Hay, Simon I.
AU - Hayat, Khezar
AU - Heidari, Golnaz
AU - Hezam, Kamal
AU - Hill, Catherine L.
AU - Hiraike, Yuta
AU - Horita, Nobuyuki
AU - Hoveidaei, Amir Human
AU - Hsiao, Alexander Kevin
AU - Hsieh, Evelyn
AU - Hussain, Salman
AU - Iavicoli, Ivo
AU - Ilic, Irena M.
AU - Islam, Sheikh Mohammed Shariful
AU - Ismail, Nahlah Elkudssiah
AU - Iwagami, Masao
AU - Jakovljevic, Mihajlo
AU - Jani, Chinmay T.
AU - Jeganathan, Jayakumar
AU - Joseph, Nitin
AU - Kadashetti, Vidya
AU - Kandel, Himal
AU - Kanko, Tesfaye K.
AU - Karaye, Ibraheem M.
AU - Khajuria, Himanshu
AU - Khan, Md Jobair
AU - Khan, Moien A.B.
AU - Khanali, Javad
AU - Khatatbeh, Moawiah Mohammad
AU - Khubchandani, Jagdish
AU - Kim, Yun Jin
AU - Kisa, Adnan
AU - Kolahi, Ali Asghar
AU - Kompani, Farzad
AU - Koohestani, Hamid Reza
AU - Koyanagi, Ai
AU - Krishan, Kewal
AU - Kuddus, Mohammed
AU - Kumar, Narinder
AU - Kuttikkattu, Ambily
AU - Larijani, Bagher
AU - Lim, Stephen S.
AU - Lo, Justin
AU - Machado, Vanessa Sintra
AU - Mahajan, Preetam Bhalchandra
AU - Majeed, Azeem
AU - Rad, Elaheh Malakan
AU - Malik, Ahmad Azam
AU - Mansournia, Mohammad Ali
AU - Mathews, Elezebeth
AU - Mendes, José João
AU - Mentis, Alexios Fotios A.
AU - Mesregah, Mohamed Kamal
AU - Mestrovic, Tomislav
AU - Mirghaderi, Seyed Peyman
AU - Mirrakhimov, Erkin M.
AU - Misganaw, Awoke
AU - Mohamadkhani, Ashraf
AU - Mohammed, Shafiu
AU - Mokdad, Ali H.
AU - Moniruzzaman, Md
AU - Al Montasir, Ahmed
AU - Mulu, Getaneh Baye
AU - Murillo-Zamora, Efrén
AU - Murray, Christopher J.L.
AU - Mustafa, Ghulam
AU - Naghavi, Mohsen
AU - Nair, Tapas Sadasivan
AU - Naqvi, Atta Abbas
AU - Natto, Zuhair S.
AU - Nayak, Biswa Prakash
AU - Neupane, Subas
AU - Nguyen, Cuong Tat
AU - Niazi, Robina Khan
AU - Nzoputam, Ogochukwu Janet
AU - Oh, In Hwan
AU - Okati-Aliabad, Hassan
AU - Okonji, Osaretin Christabel
AU - Olufadewa, Isaac Iyinoluwa
AU - Owolabi, Mayowa O.
AU - Pacheco-Barrios, Kevin
AU - Padubidri, Jagadish Rao
AU - Patel, Jay
AU - Pathan, Aslam Ramjan
AU - Pawar, Shrikant
AU - Pedersini, Paolo
AU - Perianayagam, Arokiasamy
AU - Petcu, Ionela Roxana
AU - Qattea, Ibrahim
AU - Radfar, Amir
AU - Rafiei, Alireza
AU - Ur Rahman, Mohammad Hifz
AU - Rahmanian, Vahid
AU - Rashedi, Vahid
AU - Rashidi, Mohammad Mahdi
AU - Ratan, Zubair Ahmed
AU - Rawaf, Salman
AU - Razeghinia, Mohammad Sadegh
AU - Redwan, Elrashdy Moustafa Mohamed
AU - Renzaho, Andre M.N.
AU - Rezaei, Nazila
AU - Rezaei, Nima
AU - Riad, Abanoub
AU - Saad, Aly M.A.
AU - Saddik, Basema
AU - Saeed, Umar
AU - Safary, Azam
AU - Sahebazzamani, Maryam
AU - Sahebkar, Amirhossein
AU - Sahoo, Harihar
AU - Farrokhi, Amir Salek
AU - Saqib, Muhammad Arif Nadeem
AU - Seylani, Allen
AU - Shahabi, Saeed
AU - Shaikh, Masood Ali
AU - Shashamo, Bereket Beyene
AU - Shetty, Adithi
AU - Shetty, Jeevan K.
AU - Shigematsu, Mika
AU - Shivarov, Velizar
AU - Shobeiri, Parnian
AU - Sibhat, Migbar Mekonnen
AU - Sinaei, Ehsan
AU - Singh, Ambrish
AU - Singh, Jasvinder A.
AU - Singh, Paramdeep
AU - Singh, Surjit
AU - Siraj, Md Shahjahan
AU - Skryabina, Anna Aleksandrovna
AU - Slater, Helen
AU - Smith, Amanda E.
AU - Solomon, Yonatan
AU - Soltani-Zangbar, Mohammad Sadegh
AU - Tabish, Mohammad
AU - Tan, Ker Kan
AU - Tat, Nathan Y.
AU - Tehrani-Banihashemi, Arash
AU - Tharwat, Samar
AU - Tovani-Palone, Marcos Roberto
AU - Tusa, Biruk Shalmeno
AU - Tahbaz, Sahel Valadan
AU - Valdez, Pascual R.
AU - Valizadeh, Rohollah
AU - Vaziri, Siavash
AU - Vollset, Stein Emil
AU - Wu, Ai Min
AU - GBD 2021 Rheumatoid Arthritis Collaborators
N1 - Funding Information: A Badawi is supported by the Public Health Agency of Canada. L M Bearne acknowledges support from St George's, University of London. A Bhat, J R Padubidri, and A Shetty acknowledge support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education. R Buchbinder is supported by an NHMRC Investigator Fellowship. M Cross acknowledges support from the Global Alliance for Musculoskeletal Health. I Filip and A Radfar acknowledge support from Avicenna Medical and Clinical Research Institute. V K Gupta acknowledges funding support from NHMRC, Australia. S Haque acknowledges support from Jazan University, Saudi Arabia for providing the access of the Saudi Digital Library for this study. I M Ilic is supported by Ministry of Education, Science and Technological development, Republic of Serbia, 2011–2023. S M S Islam is funded by the NHMRC Emerging Leadership Fellowship and has received grants from the National Heart Foundation of Australia. N Ismail acknowledges support from AIMST University, Malaysia, for institutional support. M Jakovljevic acknowledges support of the Ministry of Education Science and Technological Development of the Republic of Serbia. N Joseph acknowledges support from the Department of Community Medicine, Kasturba Medical College, Mangalore, India for their support and encouragement in this research study. H Kandel is supported by a Kornhauser Research Fellowship at The University of Sydney. K Krishan acknowledges non-financial support from UGC Centre of Advanced Study, Phase II, awarded to the Department of Anthropology, Panjab University, Chandigarh, India. E Mathews was supported by the DBT/Wellcome Trust India Alliance Fellowship. A R Pathan acknowledges support from Author Gate Publications. P Pedersini acknowledges support and funding by the Italian Ministry of Health Ricerca Corrente 2023. I Qattea acknowledge support from Nassau University Medical Center and Cleveland Clinic Foundation. E M M Redwan acknowledges support from King Abdulaziz University, Jeddah, and King Abdulaziz City for Science & Technology, Saudi Arabia, Science & Technology Development Fund, and US-Egypt Science & Technology joint Fund, and The Academy of Scientific Research & Technology, Egypt. A Riad was supported by the NPO “Systemic Risk Institute” funded by European Union Next Generation EU (Ministry of Education, Youth and Sports, NPO: EXCELES). U Saeed acknowledges support from the International Center of Medical Sciences Research, Islamabad, Pakistan. A Singh is supported by International Graduate Research Scholarship, University of Tasmania. M Tabish acknowledges support from the Scientific Research Unit at Shaqra University, Saudi Arabia. M R Tovani-Palone acknowledges support from Saveetha Institute of Medical and Technical Sciences and SRM Institute of Science and Technology. Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2023/10
Y1 - 2023/10
N2 - Background: Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050. Methods: Rheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (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 with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Findings: In 2020, an estimated 17·6 million (95% uncertainty interval 15·8–20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8–241·1) per 100 000 population, representing a 14·1% (12·7–15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40–2·47]). The age-standardised death rate was 0·47 (0·41–0·54) per 100 000 population (38 300 global deaths [33 500–44 000]), a 23·8% (17·5–29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000–3 860 000), with an age-standardised DALY rate of 36·4 (27·6–45·9) per 100 000 population. YLDs accounted for 76·4% (68·3–81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6–10·3). We forecast that 31·7 million (25·8–39·0) individuals will be living with rheumatoid arthritis worldwide by 2050. Interpretation: Rheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease. Funding: Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
AB - Background: Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050. Methods: Rheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (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 with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Findings: In 2020, an estimated 17·6 million (95% uncertainty interval 15·8–20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8–241·1) per 100 000 population, representing a 14·1% (12·7–15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40–2·47]). The age-standardised death rate was 0·47 (0·41–0·54) per 100 000 population (38 300 global deaths [33 500–44 000]), a 23·8% (17·5–29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000–3 860 000), with an age-standardised DALY rate of 36·4 (27·6–45·9) per 100 000 population. YLDs accounted for 76·4% (68·3–81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6–10·3). We forecast that 31·7 million (25·8–39·0) individuals will be living with rheumatoid arthritis worldwide by 2050. Interpretation: Rheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease. Funding: Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
UR - http://www.scopus.com/inward/record.url?scp=85171798862&partnerID=8YFLogxK
U2 - 10.1016/S2665-9913(23)00211-4
DO - 10.1016/S2665-9913(23)00211-4
M3 - Article
AN - SCOPUS:85171798862
SN - 2665-9913
VL - 5
SP - e594-e610
JO - The Lancet Rheumatology
JF - The Lancet Rheumatology
IS - 10
ER -