The Burden and Temporal Trends of Rheumatoid Arthritis in High-Income Countries and Territories, 1990-2023: A Systematic Analysis for the Global Burden of Disease Study 2023
Year: 2026
Type: article
Abstract: Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease causing progressive joint damage, disability, and excess mortality. Evaluating long-term epidemiological trajectories across high-resource health systems is essential for optimizing rheumatology care. This study analyzes the burden and 33-year temporal trends of RA across high-income countries and territories using Global Burden of Disease (GBD) Study 2023 estimates. Methods: We analyzed incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) across 36 high-income countries and territories (5 GBD regions: Australasia, High-income Asia Pacific, High-income North America, Southern Latin America, and Western Europe) from 1990 to 2023. To distinguish clinical risk from population growth and aging, we prioritized age-standardized rates (ASRs per 100,000) alongside absolute metrics. We present all estimates with 95% uncertainty intervals (UIs). Results: In 2023, high-income settings accounted for 0.26 million incident cases, 4.98 million prevalent cases, 0.80 million DALYs, and 10,190 deaths. From 1990 to 2023, absolute prevalent cases (+72%) and DALYs (+49%) grew substantially due to demographic aging. Conversely, underlying age-standardized incidence (17.12 [95% UI: 15.69-18.83]) and prevalence (282.80 [95% UI: 256.24-314.48]) increased modestly (+9% and +10%), while age-standardized DALY rates (44.14 [95% UI: 32.63-56.59]) fell by 7% and age-standardized death rates (0.39 [95% UI: 0.34-0.45]) decreased markedly by 41%. Australasia exhibited the highest ASRs across all metrics in 2023, whereas Southern Latin America demonstrated the sharpest ASR increases (+54% incidence, +62% prevalence, +34% DALYs). High-income Asia Pacific achieved the largest ASR reductions (-14% incidence, -12% prevalence, -26% DALYs, -49% deaths). Females and adults aged over 60 years consistently bore the primary disease burden. Conclusion: While age-standardized mortality has dropped substantially, reflecting improved management of RA and its comorbidities, the non-fatal disability burden continues to expand alongside population aging. Rheumatology health services must shift toward long-term disability management, early treat-to-target intervention, and addressing persistent regional disparities.
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,320
OpenAlex ID: W7223056222