A comprehensive analysis of trends and inequalities in rheumatoid arthritis burden among women of childbearing age: insights from the Global Burden of Disease study 2021.

Abstract

Objectives: To assess the trends and inequalities in the burden of rheumatoid arthritis (RA) among women of childbearing age (WCBA) and projects future trends at the global, regional, and national levels.

Methods: Data on RA prevalence, incidence, disability-adjusted life years (DALYs), and deaths for WCBA were sourced from the Global Burden of Diseases Study 2021. Percentage change (PC), estimated annual percentage change (EAPC), and the ARIMA model were used to analyse trends and project the burden through 2050.

Results: In 2021, the global prevalence, incidence, and DALYs cases of RA among WCBA were 4.45 million, 326.6 thousand, and 650.75 thousand, respectively, with significant increases since 1990 (PC: 88%, 68%, and 71%). Over the past 32 years, global rates for prevalence, incidence, and DALYs have all risen, with EAPC values of 0.89 (95% UI: 0.87-0.92), 0.54 (95% UI: 0.51-0.56), and 0.61 (95% UI: 0.57-0.64), respectively. Death cases and rates have decreased globally and in most regions. Among the five Socio-Demographic Index (SDI) regions, the high Socio-Demographic Index (SDI) region reported the highest rates of RA burden. By age, older age groups had higher prevalence, incidence, and DALYs, with the 45-49 age group showing the highest incidence in 2021 (59.22 thousand cases, rate of 25.13 per 10,000). However, younger groups, particularly those aged 15-19, experienced the fastest incidence growth (EAPC 0.64). By 2050, RA prevalence and DALYs rates are projected to rise to 266.34 and 37.63 per 100,000, while incidence will stabilise and deaths will continue to decline.

Conclusions: The RA burden among WCBA has significantly increased over the past 32 years, with a notable shift in risk towards younger populations. Higher SDI regions bore a disproportionately greater burden. These findings emphasise the need for increased investments and targeted RA interventions for WCBA, supporting the achievement of WHO's Sustainable Development Goal 3.