Global, regional, and national burden of rheumatoid arthritis, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Rachel Black(The University of Sydney), Marita Cross(The University of Sydney), Lydia M Haile(The University of Sydney), Garland T Culbreth(The University of Sydney), Jaimie D Steinmetz(The University of Sydney), Hailey Hagins(The University of Sydney), Jacek A Kopec(The University of Sydney), Peter Brooks(The University of Sydney), Anthony D. Woolf(The University of Sydney), Kanyin Liane Ong(The University of Sydney), Deborah Kopansky-Giles(The University of Sydney), Karsten E Dreinhoefer(The University of Sydney), Neil Betteridge(The University of Sydney), Amirali Aali(The University of Sydney), Mitra Abbasifard(The University of Sydney), Mohsen Abbasi‐Kangevari(The University of Sydney), Ame Mehadi Abdurehman(The University of Sydney), Aidin Abedi(The University of Sydney), Hassan Abidi(The University of Sydney), Richard Gyan Aboagye(The University of Sydney), Hassan Abolhassani(The University of Sydney), Eman Abu‐Gharbieh(The University of Sydney), Ahmed Abu‐Zaid(The University of Sydney), Kidist Adamu(The University of Sydney), Isaac Yeboah Addo(The University of Sydney), Miracle Ayomikun Adesina(The University of Sydney), Qorinah Estiningtyas Sakilah Adnani(The University of Sydney), Muhammad U. Afzal(The University of Sydney), Ayman Ahmed(The University of Sydney), Janardhana P Aithala(The University of Sydney), Meisam Akhlaghdoust(The University of Sydney), Astawus Alemayehu(The University of Sydney), Saba Alvand(The University of Sydney), Nelson J Alvis-Zakzuk(The University of Sydney), Hubert Amu(The University of Sydney), Benny Antony(The University of Sydney), Jalal Arabloo(The University of Sydney), Aleksandr Y. Aravkin(The University of Sydney), Judie Arulappan(The University of Sydney), Tahira Ashraf(The University of Sydney), Seyyed Shamsadin Athari(The University of Sydney), Sina Azadnajafabad(The University of Sydney), Alaa Badawi(The University of Sydney), Nayereh Baghcheghi(The University of Sydney), Atif Amin Baig(The University of Sydney), Asaminew Birhanu Balta(The University of Sydney), Maciej Banach(The University of Sydney), Palash Chandra Banik(The University of Sydney), Amadou Barrow(The University of Sydney), Azadeh Bashiri(The University of Sydney), Lindsay Bearne(The University of Sydney), Alehegn Bekele(The University of Sydney), Isabela M. Benseñor(The University of Sydney), Alemshet Yirga Berhie(The University of Sydney), Akshaya Srikanth Bhagavathula(The University of Sydney), Pankaj Bhardwaj(The University of Sydney), Ajay Nagesh Bhat(The University of Sydney), Vijayalakshmi S Bhojaraja(The University of Sydney), Saeid Bitaraf(The University of Sydney), Belay Boda Abule Bodicha(The University of Sydney), João Silva Botelho(The University of Sydney), Andrew M. Briggs(The University of Sydney), Rachelle Buchbinder(The University of Sydney), Carlos A Castañeda-Orjuela(The University of Sydney), Periklis Charalampous(The University of Sydney), Vijay Kumar Chattu(The University of Sydney), Kaleb Coberly(The University of Sydney), Natália Martins(The University of Sydney), Omid Dadras(The University of Sydney), Xiaochen Dai(The University of Sydney), Katie de Luca(The University of Sydney), Fikadu Nugusu Dessalegn(The University of Sydney), Gashaw Dessie(The University of Sydney), Meghnath Dhimal(The University of Sydney), Lankamo Ena Digesa(The University of Sydney), Mengistie Diress(The University of Sydney), Paul Narh Doku, Hisham Atan Edinur(The University of Sydney), Michael Ekholuenetale(The University of Sydney), Muhammed Elhadi(The University of Sydney), Yasser M. El‐Sherbiny(The University of Sydney), Farshid Etaee(The University of Sydney), Rana Ezzeddini(The University of Sydney), Shahriar Faghani(The University of Sydney), Irina Filip(The University of Sydney), Florian Fischer(The University of Sydney), Takeshi Fukumoto(The University of Sydney), Balasankar Ganesan(The University of Sydney), Mathewos Alemu Gebremichael(The University of Sydney), Urge Gerema(The University of Sydney), Motuma Erena Getachew(The University of Sydney), Ahmad Ghashghaee(The University of Sydney), Tiffany K. Gill(The University of Sydney), Bhawna Gupta(The University of Sydney), Sapna Gupta(The University of Sydney), Veer Bala Gupta(The University of Sydney), Vivek Gupta(The University of Sydney), Rabih Halwani(The University of Sydney), Md. Abdul Hannan(The University of Sydney), Shafiul Haque(The University of Sydney), Netanja I. Harlianto(The University of Sydney), Mehdi Harorani(The University of Sydney), Ahmed I Hasaballah(The University of Sydney), Mohammed Bheser Hassen(The University of Sydney), Simon I Hay(The University of Sydney), Khezar Hayat(The University of Sydney), Golnaz Heidari(The University of Sydney), Kamal Hezam(The University of Sydney), Catherine Hill(The University of Sydney), Yuta Hiraike(The University of Sydney), Nobuyuki Horita(The University of Sydney), Amir Human Hoveidaei(The University of Sydney), Alexander Kevin Hsiao(The University of Sydney), Evelyn Hsieh(The University of Sydney), Salman Hussain(The University of Sydney), Ivo Iavicoli(The University of Sydney), Irena Ilić(The University of Sydney), Sheikh Mohammed Shariful Islam(The University of Sydney), Nahlah Elkudssiah Ismail(The University of Sydney), Masao Iwagami(The University of Sydney), Mihajlo Jakovljević(The University of Sydney), Chinmay Jani(The University of Sydney), Jayakumar Jeganathan(The University of Sydney), Nitin Joseph(The University of Sydney), Vidya Kadashetti(The University of Sydney), Himal Kandel(The University of Sydney), Tesfaye K Kanko(The University of Sydney), Ibraheem M. Karaye(The University of Sydney), Himanshu Khajuria(The University of Sydney), Mohammad Jobair Khan(The University of Sydney), Moien AB Khan(The University of Sydney), Javad Khanali(The University of Sydney), Moawiah Khatatbeh(The University of Sydney), Jagdish Khubchandani(The University of Sydney), Yun Jin Kim(The University of Sydney), Adnan Kısa(The University of Sydney), Ali‐Asghar Kolahi(The University of Sydney), Farzad Kompani(The University of Sydney), Hamid Reza Koohestani(The University of Sydney), Ai Koyanagi(The University of Sydney), Kewal Krishan(The University of Sydney), Mohammed Kuddus(The University of Sydney), Narinder Kumar(The University of Sydney), Ambily Kuttikkattu(The University of Sydney), Bagher Larijani(The University of Sydney), Stephen S Lim(The University of Sydney), Justin Lo(The University of Sydney), Vanessa Machado(The University of Sydney), Preetam Mahajan(The University of Sydney), Azeem Majeed(The University of Sydney), Elaheh Malakan Rad, Ahmad Azam Malik(The University of Sydney), Mohammad Alì Mansournia(The University of Sydney), Elezebeth Mathews(The University of Sydney), José João Mendes(The University of Sydney), Alexios‐Fotios A. Mentis(The University of Sydney), Mohamed Kamal Mesregah(The University of Sydney), Tomislav Meštrović(The University of Sydney), Peyman Mirghaderi(The University of Sydney), Erkin М Мirrakhimov(The University of Sydney), Awoke Misganaw(The University of Sydney), Ashraf Mohamadkhani(The University of Sydney), Shafiu Mohammed(The University of Sydney), Ali H. Mokdad(The University of Sydney), Md. Moniruzzaman(The University of Sydney), Ahmed Al Montasir(The University of Sydney), Getaneh Baye Mulu(The University of Sydney), Efrén Murillo‐Zamora(The University of Sydney), Christopher J L Murray(The University of Sydney), Ghulam Mustafa(The University of Sydney), Mohsen Naghavi(The University of Sydney), Tapas Sadasivan Nair(The University of Sydney), Atta Abbas Naqvi(The University of Sydney), Zuhair S. Natto(The University of Sydney), Biswa Prakash Nayak(The University of Sydney), Subas Neupane(The University of Sydney), Cuong Tat Nguyen(The University of Sydney), Robina Khan Niazi(The University of Sydney), Ogochukwu Janet Nzoputam(The University of Sydney), In‐Hwan Oh(The University of Sydney), Hassan Okati‐Aliabad(The University of Sydney), Osaretin Christabel Okonji(The University of Sydney), Isaac Iyinoluwa Olufadewa(The University of Sydney), Mayowa Owolabi(The University of Sydney), Kevin Pacheco‐Barrios(The University of Sydney), Jagadish Rao Padubidri(The University of Sydney), Jay Patel(The University of Sydney), Aslam Pathan(The University of Sydney), Shrikant Pawar(The University of Sydney), Paolo Pedersini(The University of Sydney), Arokiasamy Perianayagam(The University of Sydney), Ionela-Roxana Petcu(The University of Sydney), Ibrahim Qattea(The University of Sydney), Amir Radfar(The University of Sydney), Alireza Rafiei(The University of Sydney), Mohammad Hifz Ur Rahman(The University of Sydney), Vahid Rahmanian(The University of Sydney), Vahid Rashedi(The University of Sydney), Mohammad‐Mahdi Rashidi(The University of Sydney), Zubair Ahmed Ratan(The University of Sydney), Salman Rawaf(The University of Sydney), Mohammad Sadegh Razeghinia(The University of Sydney), Elrashdy M. Redwan(The University of Sydney), André M. N. Renzaho(The University of Sydney), Nazila Rezaei(The University of Sydney), Nima Rezaei(The University of Sydney), Abanoub Riad(The University of Sydney), Aly M A Saad(The University of Sydney), Basema Saddik(The University of Sydney), Umar Saeed(The University of Sydney), Azam Safary(The University of Sydney), Maryam Sahebazzamani(The University of Sydney), Amirhossein Sahebkar(The University of Sydney), Harihar Sahoo(The University of Sydney), Amir Salek Farrokhi(The University of Sydney), Muhammad Arif Nadeem Saqib(The University of Sydney), Allen Seylani(The University of Sydney), Saeed Shahabi(The University of Sydney), Masood Ali Shaikh(The University of Sydney), Bereket Beyene Shashamo(The University of Sydney), Adithi Shetty(The University of Sydney), Jeevan K. Shetty(The University of Sydney), Mika Shigematsu(The University of Sydney), Velizar Shivarov(The University of Sydney), Parnian Shobeiri(The University of Sydney), Migbar Mekonnen Sibhat(The University of Sydney), Ehsan Sinaei(The University of Sydney), Ambrish Singh(The University of Sydney), Ambrish Singh(The University of Sydney), Paramdeep Singh(The University of Sydney), Surjit Singh(The University of Sydney), Md Shahjahan Siraj(The University of Sydney), Anna Aleksandrovna Skryabina(The University of Sydney), Helen Slater(The University of Sydney), Amanda Smith(The University of Sydney), Yonatan Solomon(The University of Sydney), Mohammad Sadegh Soltani‐Zangbar(The University of Sydney), Mohammad Tabish(The University of Sydney), Ker‐Kan Tan(The University of Sydney), Nathan Y Tat(The University of Sydney), Arash Tehrani‐Banihashemi(The University of Sydney), Samar Tharwat(The University of Sydney), Marcos Roberto Tovani‐Palone, Biruk Shalmeno Tusa, Sahel Valadan Tahbaz, Pascual Valdéz, Rohollah Valizadeh, Siavash Vaziri, Stein Emil Vollset, Aimin Wu(The University of Sydney), Dereje Y Yada, Sisay Shewasinad Yehualashet, Naohiro Yonemoto, Yuyi You, Ismaeel Yunusa, Moein Zangiabadian, Iman Zare(The University of Sydney), Armin Zarrintan, Zhi-Jiang Zhang, Chenwen Zhong, Mohammad Zoladl(The University of Sydney), Theo Vos, Lyn March
The Lancet Rheumatology
September 25, 2023
10.1016/s2665-9913(23)00211-4
Cited by 574Open Access
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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.

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