Background/Purpose: The burden of Rheumatoid Arthritis (RA) in the United States is considerable, both in terms of its prevalence and the economic costs it incurs. The CDC has underscored the substantial economic, personal, and societal impacts of arthritis, estimating that in 2013, the total national costs attributable to arthritis for medical care and lost earnings exceeded $300 billion. This study is unprecedented as it assesses the burden of RA over the last three decades, including the initial two years of the COVID-19 pandemic. During this period, managing non-COVID-19 conditions like RA was particularly challenging due to strained healthcare resources and shifting priorities.

Methods: Using Global burden of disease 2021, methodology we estimated the incidence, prevalence, mortality, disability adjusted life years (DALYs), years lived with disability (YLDs) due to RA by age, sex, year and location across the USA from 1990-2021.

Results: The total prevalence count rose from 751,904 (95% uncertainty interval: 689,983-817,799) in 1990 to 1.4 million (1.3-1.5 million) in 2021. Deaths increased from 1,703 (1,558-1,781) in 1990 to 2,260 (1,960-2,480) in 2021. The total percentage change (TPC) in YLDs counts surged by 90% (86%-95%) from 1990 to 2021. Regarding the age-standardized incidence rate (ASIR), Tennessee experienced the highest increase in TPC at 23%, followed by Mississippi and Georgia, each at 21%. Minnesota saw the smallest increase at 7% from 1990 to 2021. In terms of the age-standardized DALYs rate (ASDALR), the greatest increase was observed in Mississippi at 11%, followed by Oklahoma and Kansas, each at 9%, from 1990 to 2021. Among age groups, the highest incidence was noted in those aged 65-69 years at 11,793 (8,113-15,576), DALYs at 32,319 (24,187-42,329), and deaths in those aged 75-79 years at 386 (344-422) in 2021. In terms of gender, males exhibited a higher burden than females, with TPCs in incidence counts at 93% for males versus 85% for females, DALYs at 74% versus 71%, and deaths at 35% versus 28% from 1990 to 2021.

Conclusion: In conclusion, this study not only maps the evolving landscape of disease burden from 1990 to 2021 but also highlights critical insights into demographic and geographic disparities. The marked escalation in prevalence and mortality underscores the urgent need for tailored health interventions. Particularly striking is the differential growth in disease metrics across states like Tennessee and Mississippi, signaling a potential focus for targeted health policies. Furthermore, the pronounced disparity between male and female health outcomes invites deeper investigation into gender-specific healthcare strategies. As we stand on the precipice of transformative healthcare advancements, these findings beckon a strategic recalibration of public health priorities, ensuring a more equitable health future for all demographics.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cross-state-comparative-assessment-of-burden-of-rheumatoid-arthritis-in-the-united-states-and-its-trend-from-1990-2021-a-benchmarking-analysis-for-the-global-burden-of-disease-study-2022/