Rheumatoid arthritis burden in 129 low- and middle-income countries from 1990 to 2023

Area of Science:

• Rheumatology
• Global Health
• Epidemiology

Background:

• Rheumatoid arthritis (RA) is a major cause of disability globally, particularly in low- and middle-income countries (LMICs).
• Understanding the epidemiological trends of RA in LMICs is crucial for public health planning and resource allocation.
• Most of the global population resides in LMICs, making RA a significant public health concern in these regions.

Purpose of the Study:

• To assess the prevalence, incidence, mortality, and disability-adjusted life-year (DALY) rates of RA in 129 LMICs from 1990 to 2023.
• To project future trends of RA burden in LMICs up to 2050.
• To analyze RA burden disparities across different income groups (low, lower-middle, and upper-middle) within LMICs.

Main Methods:

• Utilized data from the Global Burden of Disease (GBD) 2023 study.
• Analyzed RA epidemiological metrics including prevalence, incidence, mortality, and DALYs.
• Stratified countries by gross national income (GNI) and projected trends to 2050.

Main Results:

• In 2023, RA affected 12.6 million individuals, with prevalence 4.1-fold higher in upper-middle-income countries compared to low-income countries.
• Mortality rates converged across income groups, but absolute inequality in prevalence widened.
• Projections indicate declining mortality in low-income settings and increasing mortality in middle-income countries by 2050.

Conclusions:

• Significant disparities in RA prevalence exist across income levels in LMICs.
• Addressing RA burden requires tailored strategies: enhancing diagnostic capacity in low-income countries and improving medication affordability in middle-income countries.
• Future RA management in LMICs must consider evolving epidemiological trends and economic contexts.