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

Rheumatoid arthritis (RA) causes substantial disability in low- and middle-income countries (LMICs), which account for most of the global population. Using Global Burden of Disease (GBD) 2023 data, we assessed RA prevalence, incidence, mortality, and disability-adjusted life-year (DALY) rates across 129 LMICs from 1990 to 2023 and projected trends to 2050. Countries were stratified by gross national income (GNI) into low-income, lower-middle-income, and upper-middle-income groups. In 2023, RA affected 12.6 million individuals, with prevalence in upper-middle-income countries being 4.1-fold higher than in low-income countries. Death rates converged across income groups, while absolute inequality in prevalence widened and inequality in mortality narrowed. Projections to 2050 indicated declining mortality in low-income settings but increasing in middle-income countries. Therefore, it is necessary to improve diagnostic capacity in low-income settings and medication affordability in middle-income countries.