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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 Publisher



Black RJ1 ; Cross M3, 6 ; Haile LM7 ; Culbreth GT7 ; Steinmetz JD7 ; Hagins H7 ; Kopec JA10, 11 ; Brooks PM12 ; Woolf AD6, 13 ; Ong KL7 ; Kopanskygiles DR14, 17 ; Dreinhoefer KE6, 18 ; Betteridge N20 ; Aali A21 Show All Authors
Authors
  1. Black RJ1
  2. Cross M3, 6
  3. Haile LM7
  4. Culbreth GT7
  5. Steinmetz JD7
  6. Hagins H7
  7. Kopec JA10, 11
  8. Brooks PM12
  9. Woolf AD6, 13
  10. Ong KL7
  11. Kopanskygiles DR14, 17
  12. Dreinhoefer KE6, 18
  13. Betteridge N20
  14. Aali A21
  15. Abbasifard M24, 25
  16. Abbasikangevari M27
  17. Abdurehman AM38
  18. Abedi A40
  19. Abidi H41
  20. Aboagye RG43
  21. Abolhassani H28, 45
  22. Abugharbieh E46
  23. Abuzaid A49, 50
  24. Adamu K51
  25. Addo IY52, 53
  26. Adesina MA54, 55
  27. Adnani QES59
  28. Afzal MS60
  29. Ahmed A62, 63
  30. Aithala JP64
  31. Akhlaghdoust M65, 66
  32. Alemayehu A69, 70
  33. Alvand S29
  34. Alviszakzuk NJ71, 72
  35. Amu H44
  36. Antony B74
  37. Arabloo J75
  38. Aravkin AY7, 8, 9
  39. Arulappan J78
  40. Ashraf T79
  41. Athari SS81
  42. Azadnajafabad S27
  43. Badawi A15, 82
  44. Baghcheghi N83
  45. Baig AA80
  46. Balta AB85
  47. Banach M91, 92
  48. Banik PC93
  49. Barrow A94, 95
  50. Bashiri A96
  51. Bearne LM99, 100
  52. Bekele A86
  53. Bensenor IM101
  54. Berhie AY102
  55. Bhagavathula AS103
  56. Bhardwaj P104, 105
  57. Bhat AN107
  58. Bhojaraja VS110
  59. Bitaraf S112
  60. Bodicha BBA87
  61. Botelho JS113
  62. Briggs AM114
  63. Buchbinder R115, 116
  64. Castanedaorjuela CA73, 117
  65. Charalampous P118
  66. Chattu VK16, 119
  67. Coberly K7
  68. Cruzmartins N120, 121
  69. Dadras O122, 123
  70. Dai X7, 9
  71. De Luca K124
  72. Dessalegn FN125
  73. Dessie G126
  74. Dhimal M128
  75. Digesa LE88
  76. Diress M127
  77. Doku PN129
  78. Edinur HA130
  79. Ekholuenetale M56, 57
  80. Elhadi M131
  81. Elsherbiny YM132, 133
  82. Etaee F135
  83. Ezzeddini R138
  84. Faghani S30
  85. Filip I139, 140
  86. Fischer F19
  87. Fukumoto T141
  88. Ganesan B142, 143
  89. Gebremichael MA89
  90. Gerema U144
  91. Getachew ME144, 145
  92. Ghashghaee A146
  93. Gill TK147
  94. Gupta B148
  95. Gupta S149
  96. Gupta VB150
  97. Gupta VK151
  98. Halwani R46, 47
  99. Hannan MA153, 154
  100. Haque S155
  101. Harlianto NI156, 157
  102. Harorani M158
  103. Hasaballah AI159
  104. Hassen MB7, 160
  105. Hay SI7, 9
  106. Hayat K161, 162
  107. Heidari G163
  108. Hezam K164, 165
  109. Hill CL2, 147
  110. Hiraike Y166
  111. Horita N167, 168
  112. Hoveidaei AH169
  113. Hsiao AK170
  114. Hsieh E136, 171
  115. Hussain S172, 173
  116. Iavicoli I175
  117. Ilic IM176
  118. Islam SMS4, 177
  119. Ismail NE178, 179
  120. Iwagami M180, 181
  121. Jakovljevic M182, 183
  122. Jani CT184
  123. Jeganathan J107
  124. Joseph N108
  125. Kadashetti V185
  126. Kandel H5, 186
  127. Kanko TK87
  128. Karaye IM187
  129. Khajuria H188
  130. Khan MJ189
  131. Khan MAB190, 191
  132. Khanali J27, 67
  133. Khatatbeh MM192
  134. Khubchandani J193
  135. Kim YJ194
  136. Kisa A195, 196
  137. Kolahi AA67
  138. Kompani F31
  139. Koohestani HR84
  140. Koyanagi A197
  141. Krishan K198
  142. Kuddus M199
  143. Kumar N200
  144. Kuttikkattu A201
  145. Larijani B32
  146. Lim SS7, 9
  147. Lo J7
  148. Machado VS113
  149. Mahajan PB202
  150. Majeed A203
  151. Rad EM33
  152. Malik AA80, 204
  153. Mansournia MA34
  154. Mathews E206
  155. Mendes JJ207
  156. Mentis AFA208
  157. Mesregah MK209
  158. Mestrovic T7, 210
  159. Mirghaderi SP35
  160. Mirrakhimov EM211, 212
  161. Misganaw A9, 160
  162. Mohamadkhani A36
  163. Mohammed S213, 214
  164. Mokdad AH7, 9
  165. Moniruzzaman M215
  166. Al Montasir A216, 217
  167. Mulu GB218
  168. Murillozamora E219, 220
  169. Murray CJL7, 9
  170. Mustafa G221, 223
  171. Naghavi M7, 9
  172. Nair TS224
  173. Naqvi AA225
  174. Natto ZS205, 226
  175. Nayak BP188
  176. Neupane S228
  177. Nguyen CT229
  178. Niazi RK230
  179. Nzoputam OJ231, 232
  180. Oh IH233
  181. Okatialiabad H234
  182. Okonji OC235
  183. Olufadewa II54, 57
  184. Owolabi MO58, 236
  185. Pachecobarrios K227, 237
  186. Padubidri JR238
  187. Patel J239, 240
  188. Pathan AR222, 241
  189. Pawar S137
  190. Pedersini P242
  191. Perianayagam A243
  192. Petcu IR244
  193. Qattea I245
  194. Radfar A246
  195. Rafiei A247, 248
  196. Ur Rahman MH249
  197. Rahmanian V250
  198. Rashedi V251
  199. Rashidi MM27, 67
  200. Ratan ZA252, 253
  201. Rawaf S203, 254
  202. Razeghinia MS255, 257
  203. Redwan EMM258, 259
  204. Renzaho AMN260, 261
  205. Rezaei N27
  206. Rezaei N27
  207. Riad A172, 174
  208. Saad AMA263
  209. Saddik B48
  210. Saeed U264, 265
  211. Safary A266
  212. Sahebazzamani M26, 256
  213. Sahebkar A22, 23
  214. Sahoo H243
  215. Farrokhi AS269
  216. Saqib MAN61, 270
  217. Seylani A271
  218. Shahabi S97
  219. Shaikh MA272
  220. Shashamo BB90
  221. Shetty A109
  222. Shetty JK111
  223. Shigematsu M273
  224. Shivarov V274, 275
  225. Shobeiri P37, 276
  226. Sibhat MM277
  227. Sinaei E98
  228. Singh A74
  229. Singh JA278, 279
  230. Singh P280
  231. Singh S106
  232. Siraj MS281
  233. Skryabina AA282
  234. Slater H114
  235. Smith AE7
  236. Solomon Y283
  237. Soltanizangbar MS267
  238. Tabish M222
  239. Tan KK284
  240. Tat NY285, 286
  241. Tehranibanihashemi A76, 77
  242. Tharwat S134
  243. Tovanipalone MR287, 288
  244. Tusa BS39
  245. Tahbaz SV289, 290
  246. Valdez PR291, 292
  247. Valizadeh R293
  248. Vaziri S294
  249. Vollset SE7, 9
  250. Wu AM295
  251. Yada DY7
  252. Yehualashet SS218
  253. Yonemoto N296, 297
  254. You Y5, 152
  255. Yunusa I298
  256. Zangiabadian M68
  257. Zare I299
  258. Zarrintan A268
  259. Zhang ZI300
  260. Zhong C301
  261. Zoladl M42
  262. Vos T7, 9
  263. March LM3, 302

Source: The Lancet Rheumatology Published:2023


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. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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