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The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review

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Abstract

The objective is to determine the global population prevalence of rheumatoid arthritis (RA) based on population-based studies and assess factors that influence RA prevalence estimates. Four electronic databases were searched (ProQuest Central, MEDLINE, Web of Science, and EMBASE) for peer-reviewed English publications that report prevalence estimates of RA from 1980 and 2019. We included case–control studies, cross-sectional studies, and prospective or retrospective cohort studies in our search strategy. A random-effect meta-analysis model was used to produce the pooled prevalence estimates. The potential between-study heterogeneity was identified using sensitivity analysis, sub-group and meta-regression analyses. A total of 67 studies were included in the meta-analysis, containing 742,246 RA patients and 211,592,925 healthy controls in the study period. The global RA prevalence estimate was 0.46% (95% confidence interval [CI] 0.39–0.54; I2 = 99.9%) with a 95% prediction interval (0.06–1.27). The RA point-prevalence was 0.45% (95% CI 0.38–0.53%) between 1986 and 2014, while the pooled period-prevalence was 0.46% (95% CI 0.36% and 0.57%) from 1955 to 2015. The highest RA pooled prevalence (0.69%; 95% CI 0.47–0.95) was derived from linked data source studies. Based on meta-regression, the factors that explain the studies' heterogeneity of RA prevalence, including geographical location, the risk bias assessment of studies and sample size. The global prevalence of RA between 1980 and 2019 was 460 per 100,000 population, with variations due to geographical location and study methodology. Linked data are the preferred method to estimate RA population prevalence as they provide the best case ascertainment.

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Acknowledgements

KA was supported by an Australian Government Research Training Program PhD Scholarship at the University of Western Australia (UWA). We acknowledge senior librarian Samantha Blake (SB) for her help within the scope of UWA library support services for systematic reviewers.

Funding

This meta-analysis was not funded, and no funding agencies had input into the design or conduct of this review.

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Authors and Affiliations

  1. School of Medicine, The University of Western Australia, Perth, Australia

    Khalid Almutairi, Johannes Nossent, Helen Keen & Charles Inderjeeth

  2. King Fahd Specialist Hospital, Burydah, Saudi Arabia

    Khalid Almutairi

  3. Sir Charles Gairdner and Osborne Park Health Care Group, Perth, Australia

    Johannes Nossent & Charles Inderjeeth

  4. School of Population and Global Health, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia

    David Preen

  5. Fiona Stanley Hospital, Murdoch, WA, Australia

    Helen Keen

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  1. Khalid Almutairi
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Contributions

Conceptualization: KA, JN, DP, and CI. Data curation: KA, JN, and CI. Formal analysis: KA, JN, and CI. Software: KA. Writing—original draft: KA. Writing—review and editing: KA, JN, DP, HK, and CI. Supervision: JN, DP, HK, and CI.

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Correspondence to Khalid Almutairi.

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This meta-analysis relies solely on data obtained from published research literature and, therefore, obtaining institutional ethical approval was not required.

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Almutairi, K., Nossent, J., Preen, D. et al. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int 41, 863–877 (2021). https://doi.org/10.1007/s00296-020-04731-0

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