Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome

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Epidemiology of rheumatoid arthritis: determinants of onset, persistence and

outcome

Deborah P. M. Symmons

p 707-722, Volume 16, Number 5, December 2002

Abstract

Rheumatoid arthritis (RA) is the most common chronic inflammatory joint

disease. There is some evidence that it may have been brought from North

America to Europe during the 18th century. Its arrival in rural parts of the

developing world is still more recent. The incidence and prevalence of RA

appear to have fallen in Europe, North America and Japan in the last 50

years. During this time the peak age of onset has risen. Risk factors for

the development of RA include genetic factors, an adverse pregnancy outcome,

smoking, obesity and recent infections. The oral contraceptive pill and some

dietary constituents may be protective. Older age and female gender are risk

factors both for the development of RA and for a worse outcome. This risk

factor profile offers some opportunities for primary and secondary

prevention. However, treatment is the greatest determinant of RA outcome.