Marita Cross, PhD, on the Global Burden of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a major public health challenge and significantly contributes to global disability.

In a recent study, Marita Cross, PhD, a research fellow from the Institute of Bone and Joint Research at the University of Sydney in Australia, and colleagues evaluated data from the Global Burden of Disease study to determine the prevalence, incidence, and disability-adjusted life years of RA in 195 countries from 1990 to 2017.

Findings from the study indicated that RA remains a major global public health challenge and that the age-standardized prevalence and incidence rates of RA are increasing, particularly in Canada, Paraguay, and Guatemala.

Consultant360 caught up with Dr Cross about the research.

Consultant360: What prompted you to conduct the study?

Marita Cross: An updated global study on RA has not been published since 2010. The Global Burden of Disease study is conducted by the Institute for Health Metrics and Evaluation at the University of Washington, and these data are based on modeling and are publicly available. While the data are very important, we should remember that they do not fully incorporate all the ways musculoskeletal conditions impact the individual regarding ability to function, the impact on employment, and general quality of life.

C360: What was the most surprising finding of the study?

MC: The age-standardized prevalence and incidence rates of RA are increasing, especially in countries such as Canada, Paraguay, and Guatemala. We also found that RA prevalence has increased by 7.4% and RA incidence has increased by 8.2% globally since 1990. It is important to remember these rates are based on modeled data.

C360: Why do you think RA remains a major global public health challenge?

MC: Smoking is recognized as a risk factor for the development of seropositive RA. RA disease onset may be prevented in genetically susceptible individuals if they avoid beginning smoking in the first place. Early diagnosis and early treatment are important strategies for reducing the damage and disability associated with RA. Greater awareness of the risk factors and early treatment benefits and services to care for patients with RA could make an important difference.

C360: What are the key takeaways for rheumatologists about the global burden of RA?

MC: Data on global population incidence and prevalence of RA are scarce. The quality of health data needs to improve for better monitoring of disease burden. Despite improved treatments in high-income countries, RA remains an important global burden. Greater recognition, earlier diagnosis, and more treatments are needed worldwide.


Safiri S, Kolahi AA, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis. 2019;78(11):1463-1471. doi:10.1136/annrheumdis-2019-215920