Global epidemiology of rheumatoid arthritis

By A. Finckh, B. Gilbert, B. Hodkinson, S. Bae, Ranjeny Thomas, K. Deane, D. Alpízar-Rodríguez, K. Lauper. Nature Reviews Rheumatology, 2022

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Rheumatoid arthritis (RA) is a systemic autoimmune disease that predominantly affects the joints. The prevalence of RA varies globally, with generally a higher prevalence in industrialized countries, which may be explained by exposures to environmental risk factors, but also by genetic factors, differing demographics and under-reporting in other parts of the world. Over the past three decades, strong trends of the declining severity of RA probably reflect changes in treatment paradigms and overall better management of the disease. Other trends include increasing RA prevalence. Common risk factors for RA include both modifiable lifestyle-associated variables and non-modifiable features, such as genetics and sex. A better understanding of the natural history of RA, and of the factors that contribute to the development of RA in specific populations, might lead to the introduction of specific prevention strategies for this debilitating disease. In this Review, the authors summarize and discuss regional differences in the prevalence and incidence of rheumatoid arthritis (RA), and describe temporal trends associated with the disease as well as evidence related to risk factors. The estimated prevalence and disease burden of rheumatoid arthritis (RA) vary considerably between geographic regions, with generally higher estimates in industrialized countries and urban settings. Aspects involved in the disparity in RA prevalence between populations include genetic factors, environmental exposures, demographics, socioeconomics and reporting of the disease. Despite rising RA prevalence, the severity, mortality and disease-associated comorbidities seem to be decreasing. The aetiopathogenesis of RA involves interaction between predisposing genetic factors and environmental triggers, mostly at mucosal sites (oral cavity, respiratory system and intestinal tract), resulting in the ‘mucosal origin’ hypothesis. Many RA risk factors are modifiable, including dietary habits and inhalation of pollutants such as tobacco smoke; modifications are being incorporated in prevention strategies. The estimated prevalence and disease burden of rheumatoid arthritis (RA) vary considerably between geographic regions, with generally higher estimates in industrialized countries and urban settings. Aspects involved in the disparity in RA prevalence between populations include genetic factors, environmental exposures, demographics, socioeconomics and reporting of the disease. Despite rising RA prevalence, the severity, mortality and disease-associated comorbidities seem to be decreasing. The aetiopathogenesis of RA involves interaction between predisposing genetic factors and environmental triggers, mostly at mucosal sites (oral cavity, respiratory system and intestinal tract), resulting in the ‘mucosal origin’ hypothesis. Many RA risk factors are modifiable, including dietary habits and inhalation of pollutants such as tobacco smoke; modifications are being incorporated in prevention strategies.

Subfields: Genetics, Rheumatology

View Paper: https://www.semanticscholar.org/paper/373e343a199c785ae88058e3f80ecc32d620d187