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. 2023 Feb 6;12(4):1291.
doi: 10.3390/jcm12041291.

The Burden of Rheumatoid Arthritis: Findings from the 2019 Global Burden of Diseases Study and Forecasts for 2030 by Bayesian Age-Period-Cohort Analysis

Yuanqing Cai  1 , Jianan Zhang  2 , Jialin Liang  1 , Mofan Xiao  3 , Guangyang Zhang  1 , Zhaopu Jing  1 , Leifeng Lv  1 , Kai Nan  4 , Xiaoqian Dang  1
Affiliations

The Burden of Rheumatoid Arthritis: Findings from the 2019 Global Burden of Diseases Study and Forecasts for 2030 by Bayesian Age-Period-Cohort Analysis

Yuanqing Cai et al. J Clin Med. .

Abstract

Background: Rheumatoid arthritis (RA) is a key health issue worldwide. Due to early identification and effective treatment strategies, the disease pattern of RA has also changed. However, the most comprehensive and up-to-date information about the burden of RA and its trends in subsequent years is lacking.

Objective: this study aimed to report the global burden of RA by sex, age, region, and forecast for 2030.

Method: Publicly available data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used in this study. The trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of RA from 1990 to 2019 were reported. The global burden of RA in 2019 was reported by a sex, age, and sociodemographic index (SDI). Finally, the trends in the following years were predicted by Bayesian age-period-cohort (BAPC) models.

Results: Globally, the age-standardized prevalence rate increased from 207.46 (95% UI:189.99 to 226.95) in 1990 to 224.25 (95% UI: 204.94 to 245.99) in 2019, with an estimated annual percent change (EAPC) of 0.37% (95% CI: 0.32 to 0.42). Regarding the incidence, the age-standardized incidence rate (ASR) increased from 12.21 (95% UI: 11.13 to 13.38) to 13 (95% UI: 11.83 to 14.27) per 100,000 people from 1990 to 2019, with an EAPC of 0.3% (95% CI: 11.83 to 14.27). The age-standardized DALY rate also increased from 39.12 (95% UI: 30.13 to 48.56) per 100,000 people in 1990 to 39.57 (95% UI: 30.51 to 49.53) in 2019, with an EAPC of 0.12% (95% CI: 0.08% to 0.17%). There was no significant association between the SDI and ASR when the SDI was lower than 0.7, while there was a positive association between the SDI and ASR when the SDI was higher than 0.7 The BAPC analysis showed that the ASR was estimated to be up to 18.23 in females and approximately 8.34 per 100,000 people in males by 2030.

Conclusion: RA is still a key public health issue worldwide. The global burden of RA has increased over the past decades and will continue to increase in the coming years, and much more attention should be given to early diagnosis and treatment to reduce the burden of RA.

Keywords: disability-adjusted life years; global burden of disease; incidence; prevalence; rheumatoid arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The number and age-standardized rates of incidence (A) and DALYs (B) by sex, age, and SDI in 2019. The incidence increased from 5 to 54 years and decreased from 55 years. The 50–54 age group had the highest incidence (A); the number of DALYs increased from 5 to 69 years and then decreased, and the 65–59 age group had the highest number of DALYs (B). SDI: sociodemographic index; DALYs: disability-adjusted life years.
Figure 2
Figure 2
The global disease burden of rheumatoid arthritis for both sexes in 204 countries and territories. (A) The ASR of rheumatoid arthritis in 2019, the largest ASR was observed in Ireland, followed by Finland, Kazakhstan, Mexico, and Honduras. (B) The EAPC of rheumatoid arthritis in 2019: Equatorial Guinea had the highest increase rate of ASR, followed by Bhutan, Peru, Turkey, and Bangladesh. ASR: age-standardized incidence rate; EAPC: estimated annual percent change.
Figure 3
Figure 3
The association between the ASR and SDI at the regional (A) and national (B) levels. There was no significant association between the SDI and ASR when the SDI was lower than 0.7, while there was a positive association between the SDI and ASR when the SDI was higher than 0.7. ASR: age-standardized incidence rate; SDI: sociodemographic index.
Figure 4
Figure 4
Risk factors for rheumatoid arthritis in 1990 (A) and 2019 (B). The RA-related risk factor analysis results showed that smoking was the only risk factor for DALYs due to RA based on the 2019 GBD.
Figure 5
Figure 5
Trends in ASR from 2019 to 2030 among females (A) and males (B) predicted by Bayesian age-period-cohort (BAPC) models. ASR: age-standardized incidence rate. Generally, the ASR will increase in the following years both among males and females.
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