Rheumatology International

, Volume 39, Issue 3, pp 541–549 | Cite as

Secular trends in the incidence and prevalence of rheumatoid arthritis within members of an integrated health care delivery system

  • Aniket A. KawatkarEmail author
  • Sherine E. Gabriel
  • Steven J. Jacobsen
Public Health


The study objective was to estimate secular trends in the overall incidence rate (IR) and prevalence rate (PR) of rheumatoid arthritis (RA); and subgroup-specific IR and PR by race, ethnicity, and sex in a multi-ethnic population of a large integrated health care delivery system. An ecological study was conducted within the adult population of Kaiser Permanente Southern California health plan. From January 1995 up to and including December 2014, annual IR and PR were calculated separately by race, ethnicity, sex and pooled overall. Depending on the stationarity of each ecological series, annual percentage change in IR and PR was evaluated using auto-regressive integrated moving average models. Average overall IR was 53 [95% confidence interval (CI) 46, 61] per 100,000 person-years. The overall as well as subgroup-specific annual IR of RA were unchanged from 1995 to 2014. In 1995, the overall PR of RA was 59 (44, 74) per 100,000 person-years which increased by 14% (7%, 21%) annually thereafter. The increase in PR in Caucasians was lower as compared to African American, Asian and other race (13% vs 15%, 15%, and 18%, respectively). Compared to non-Hispanic ethnicity, the increase in PR among Hispanic was higher (17% vs 14%). Over the past 2 decades, while the incidence of RA was unchanged, the prevalence had increased significantly overall as well as within every subgroup of race, ethnicity, and sex.


Rheumatoid arthritis Incidence Prevalence Secular trends Box–Jenkins models 



There was no funding received for this study.

Compliance with ethical standards

Conflict of interest

Aniket A. Kawatkar, Sherine E. Gabriel, and Steven J. Jacobsen have no direct conflict of interests. Dr. Kawatkar reports grants from Medac Pharma, grants from Bristol-Myers Squibb, outside the submitted work.

Ethical approval

The study was approved by the Kaiser Permanente Southern California Institutional Review Board.

Supplementary material

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Supplementary material 3 (DOCX 15 KB)
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Supplementary material 4 (DOCX 16 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Research and EvaluationKaiser Permanente Southern CaliforniaPasadenaUSA
  2. 2.Rutgers Robert Wood Johnson Medical SchoolNew BrunswickUSA
  3. 3.Division of Rheumatology, Department of Health Sciences ResearchMayo Clinic College of MedicineRochesterUSA

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