Predictions of rheumatoid arthritis burden in 204 countries and territories by 2044: based on the Global Burden of Disease Study 2021.

Abstract

Objectives: We conducted a comprehensive analysis of the spatiotemporal dynamics of rheumatoid arthritis (RA), including age‑standardised prevalence (ASPR), incidence (ASIR), and disability‑adjusted life years (DALYs, ASDR), from 1990 to 2021, and projected trends through 2044 using data from the Global Burden of Disease (GBD) 2021 to inform and strengthen global prevention, control strategies, and public health policy for RA.

Methods: ASPR, ASIR, and ASDR estimates for 204 countries and territories (1990-2021) were retrieved from GBD 2021. We quantified temporal trends by the estimated annual percentage change (EAPC) and average annual percentage change (AAPC). We examined gender‑age‑specific differences in ASPR, ASIR, and ASDR and the relationships between RA‑related DALYs and risk factors across strata. What's more, we employed AutoRegressive Integrated Moving Average (ARIMA) and the Nordpred age‑period‑cohort model to forecast prevalence and incidence through 2044. All statistical analyses were performed in R 4.4.1 and Joinpoint Trend Analysis Software.

Results: Between 1990 and 2021, global ASPR and ASIR rose (AAPC: 0.44 and 0.40, respectively), while ASDR declined modestly (AAPC: -0.03). In 2021, Ireland exhibited the highest ASPR (529.08) and ASIR (35.08), whereas Mexico recorded the highest ASDR (87.45). Although higher sociodemographic index (SDI) regions bore a greater RA burden overall, lower SDI regions experienced more rapid increases. Across all metrics, women - particularly those aged ≥60 years - demonstrated higher rates than men. 'Smoking' emerged as a vital risk of DALYs across age groups, genders, and regions. Projections from Nordpred and ARIMA model indicate continued rapid growth in prevalence and incidence cases through 2044, with more gradual increases in ASPR and ASIR.

Conclusions: Global prevalence and incidence of RA are projected to rise further. Detailed knowledge of these trends and their drivers is essential to inform targeted interventions and mitigate the worldwide impact of RA.