Arthritis

Updated 17 December 2015

Lifetime arthritis risk higher than reported

The lifetime risk of rheumatoid arthritis (RA) and other primary inflammatory autoimmune rheumatic diseases is higher than previously understood, reserachers report online in the 28 December Arthritis & Rheumatism.

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"The lifetime risk of RA is commonly misunderstood and miscommunicated as a risk of about 1 in 100 based upon the prevalence of RA, which is 0.5% to 1%," say Dr Sherine E. Gabriel and colleagues from Mayo Clinic College of Medicine, Rochester, Minnesota.

"The lifetime risks of RA and other rheumatic diseases have not been estimated previously."

The research

To address this issue, the authors used data from the Rochester Epidemiology Project to estimate the lifetime risk of RA and other rheumatic diseases, including systemic lupus erythematosus (SLE), psoriatic arthritis (PsA), polymyalgia rheumatica (PMR), giant cell arteritis (GCA), ankylosing spondylitis (AS) and Sjögren's syndrome (SS).

The cumulative lifetime risk of developing adult-onset RA in the year 2000 was 3.6% for women (about 1 in 28) and 1.7% for men (about 1 in 59).

The cumulative risk of RA rises steeply around age 60 years in both men and women (the age at which the incidence of RA is highest) and flattens after age 80 years.

The findings

Results were similar in the year 1970, when both incidence and mortality rates were substantially higher than current rates, and 1980, when incidence and mortality rates were declining.

The investigators estimate the lifetime risk of any of the inflammatory autoimmune rheumatic diseases at 8.42% for women (about 1 in 12) and 5.13% for men (about 1 in 20).

The incidence of primary inflammatory autoimmune rheumatic diseases peaks near age 80 years in both men and women.

Smaller than lifetime risks

The lifetime risks of RA and primary inflammatory autoimmune rheumatic disease, while greater than previously understood, are nevertheless smaller than the lifetime risks of such common conditions as hip fracture (15.8% for women and 6% for men at age 50) and dementia (10% overall at age 70).

"These results can serve as useful guides in counselling patients regarding their lifetime risk of these conditions and have important implications for disease awareness campaigns," the researchers conclude.

Further investigations are needed "to determine whether identification of persons with high genetic risk for rheumatoid arthritis might justify early detection and intervention to prevent progression to overt clinical disease," they add. (Reuters Health / January 2011)

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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