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.
- 1Department of Occupational Therapy, Duchess of Kent Children's Hospital, Hong Kong, People's Republic of China.
- 2Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
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.
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BibTeX
@article{mak2026burden,
title = {{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.}},
author = {Tsui Chi Mak and Celine Cinlin Tang and Jenny Man Chik Choi and Karlen Ka Pui Law and Angie Yuen Kiu Wong and Kenney Ki Lee Lau},
journal = {Open access rheumatology : research and reviews},
year = {2026},
month = oct,
doi = {10.2147/oarrr.s635815},
url = {https://europepmc.org/article/MED/42928873},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - 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.
AU - Tsui Chi Mak
AU - Celine Cinlin Tang
AU - Jenny Man Chik Choi
AU - Karlen Ka Pui Law
AU - Angie Yuen Kiu Wong
AU - Kenney Ki Lee Lau
PY - 2026
DA - 2026/10/21
JO - Open access rheumatology : research and reviews
DO - 10.2147/oarrr.s635815
UR - https://europepmc.org/article/MED/42928873
AB - 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.
SN - 1179-156X
ER -