Background/Purpose: Rheumatoid arthritis (RA) is a growing public health concern in the United States, with increasing prevalence and disease burden over recent decades. This study evaluates national time trends in RA prevalence, mortality, and Disability-Adjusted Life Years (DALYs) from 1990 to 2021, with a focus on gender-specific differences.

Methods: Data were extracted from the Global Burden of Disease (GBD) 2021 database. Linear regression models were used to assess time trends in RA-related prevalence, mortality, and DALYs per 100,000 population, with the year as the independent variable. Analyses were stratified by gender, and trends were evaluated using slope estimates, 95% confidence intervals (CIs), p-values, and R-squared (R²) values.

Results: Nationally, RA prevalence increased significantly from 286.2 to 438.8 per 100,000 between 1990 and 2021 (slope = 5.5/year, 95% CI: 5.0–6.0, p < 0.0001, R² = 0.98). DALYs rose from 50.4 to 68.2 per 100,000 (slope = 0.6/year, 95% CI: 0.5–0.7, p < 0.0001, R² = 0.94). Mortality remained stable (0.67 to 0.68 per 100,000; slope = -0.001/year, 95% CI: -0.005 to 0.003, p = 0.52, R² = 0.01). Stratified analysis revealed that females bore a higher RA burden. Female prevalence rose from 436.8 to 641.5 per 100,000 (slope = 7.8/year, 95% CI: 7.4–8.2, p < 0.0001, R² = 0.98), compared to males (148.3 to 229.0; slope = 3.1/year, 95% CI: 2.9–3.3, p < 0.0001, R² = 0.97). DALYs for females increased from 74.8 to 98.6 per 100,000 (slope = 0.9/year, 95% CI: 0.8–1.0, p < 0.0001), while males increased from 27.8 to 36.7 (slope = 0.3/year, 95% CI: 0.3–0.4, p < 0.0001). Mortality declined slightly in males (0.39 to 0.38; slope = -0.002/year, p = 0.0068), while remaining unchanged in females (0.94 to 0.97; p = 0.863).

Conclusion: Rheumatoid arthritis continues to impose a rising and disproportionate burden on the U.S. population, with sharp increases in both prevalence and disability over the past three decades—particularly among women. While mortality has stabilized or modestly declined, the persistent rise in DALYs reflects significant unmet needs in disease control, long-term management, and quality of life. These findings signal a critical need for renewed public health attention and tailored intervention strategies to reduce disease burden and improve outcomes.

Temporal Trends in RA Prevalence, DALYs, and Mortality in the US (1990–2021) Line plots with scatter points showing annual values for RA prevalence (per 100,000), DALYs (per 100,000), and mortality (per 100,000) from 1990 to 2021. Each metric is displayed in a separate panel, highlighting the upward trends in prevalence and DALYs, and the stable mortality trend.

Gender Disparities in RA Prevalence, DALYs, and Mortality in the US (1990–2021)

Faceted line plots with scatter points comparing RA metrics between males (blue solid lines) and females (red dashed lines) from 1990 to 2021. Panels for prevalence, DALYs, and mortality illustrate the steeper increases in prevalence and DALYs for females, alongside a slight decline in male mortality and stable female mortality.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/trends-and-gender-disparities-in-rheumatoid-arthritis-burden-in-the-united-states-a-population-based-time-trend-analysis-using-the-global-burden-of-disease-database-1990-2021/