Global RA burden ‘significant, yet under-recognized’
medwireNews: Almost 20 million people worldwide were living with rheumatoid arthritis (RA) in 2017, with over a million new cases diagnosed each year, according to estimates from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study.
Marita Cross (University of Sydney, New South Wales, Australia) and colleagues say their findings “serve to highlight the significant, yet under-recognised, global burden of RA.”
They add: “Early identification and treatment of RA is vital especially among females, in order to reduce the burden and disability associated with this condition and to provide appropriate care for this community.”
Following a systematic review of data from GBD study 2017, Cross and team found that there were 19,965,115 prevalent cases of RA across the 195 countries included in the study.
This gave an age-standardized prevalence rate of 246.6 cases per 100,000 people, which corresponded to a 7.4% increase in prevalence from 1990 when the first data were collected.
In addition, there were 1,204,599 incident cases of RA globally in 2017, giving an age-standardized incidence rate of 14.9 cases per 100,000 people, corresponding to an increase of 8.2% from 1990.
By contrast, the global rate of age-standardized RA disability adjusted life–years (DALYs) fell by 3.6% between 1990 and 2017, reaching 43.3 per 100,000 people in the current analysis. However, the researchers note that although the rate fell overall, this was due to a decrease between 1990 and 2012, which was followed by a “higher than expected” increase in the subsequent 5 years.
Further analysis showed that age-standardized prevalence and DALY rates increased with age and peaked at 70–74 years among women and 75–79 years among men, with rates higher among women than men across all age groups.
Nationally, the UK had the highest age-standardized prevalence and incidence rates in 2017, at 471.8 and 27.5 cases per 100,000 people, respectively. The lowest rates were in Sri Lanka, at 97.2 and 5.9 cases per 100,000 people, respectively
Furthermore, the percentage change in age-standardized prevalence and incidence rates between 1990 and 2017 differed substantially among the countries, with the largest increases observed in Canada (54.7% and 48.2%, respectively), Paraguay (41.8% and 43.6%), and Guatemala (37.0% and 36.8%).
Writing in the Annals of the Rheumatic Diseases, Cross and co-authors point out that the GBD study data were primarily derived from modelling as very few countries had true population-based data available for RA incidence and prevalence.
Therefore “these national estimates should be interpreted with caution,” they say, adding that “[i]mproving health data for better monitoring of disease burden and health outcomes are strongly suggested.”
By Laura Cowen
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