Epidemiology and outcomes of rheumatoid arthritis

This review aims to summarize recent developments in the epidemiology of rheumatoid arthritis (RA) focusing on disease burden, risk factors, and disease outcomes.

Globally, the prevalence of RA is increasing, affecting an estimated 17.6 million people worldwide. Emerging data implicate other environmental and occupational inhaled exposures apart from cigarette smoking as RA risk factors. Risk models integrating clinical, serological, and imaging data are useful in predicting the pre-RA to RA transition. Extra-articular manifestations and multimorbidity are key complications of RA that drive excess mortality and avoidable hospitalizations, though overall mortality trends in RA are improving. RA-associated interstitial lung disease is recognized to affect the lungs of early RA patients, and risk models based on clinical and advanced biomarker phenotyping have shown potential for risk stratification. Large cohort studies have identified heart failure and valvular heart disease as cardiovascular complications in RA, in addition to atherosclerosis. Observational studies continue to evaluate the safety of TNF inhibitors in the setting of cancer.

RA prevalence is rising globally, while mortality rates are declining. Continued investigation aimed at elucidating RA risk factors, the transition from pre-RA to RA, extra-articular involvement, and multimorbidity remains critical to optimize patient outcomes.