REVIEW - Incidence and prevalence of RA, based on the 1987 ACR criteria

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Semin Arthritis Rheum. 2006 Dec;36(3):182-8. Epub 2006 Oct 11. Links

Incidence and prevalence of rheumatoid arthritis, based on the 1987

American College of Rheumatology criteria: a systematic

review.Alamanos Y, Voulgari PV, Drosos AA.

Department of Hygiene and Epidemiology, Medical School, University of

Ioannina, Ioannina, Greece.

OBJECTIVES: To conduct a systematic review of incidence and prevalence

studies of rheumatoid arthritis (RA), based on the 1987 revised

American College of Rheumatology (ACR) criteria, to compare their

methodologies and summarize their results, and to investigate the

possible geographic variations and changes over time in the frequency

of the disease. METHODS: We conducted a Medline search between January

1988 and December 2005. Studies reporting the incidence and prevalence

of RA in adult populations (16 to 20 years and over), based on 1987

ACR criteria, were eligible for inclusion. From each study included,

we extracted the country, year of publication, type of study

(retrospective, prospective, or cross-sectional), and incidence or

prevalence rates. The study areas were grouped into (a) North American

countries; ( north European countries; © south European countries;

and (d) developing countries. We examined the geographical differences

of prevalence and incidence rates using the Mann-Whitney and the

Kruskall-Wallis tests. RESULTS: A total of 28 studies were identified

meeting the inclusion criteria. Nine were incidence studies, 17 were

prevalence studies, and 2 estimated both prevalence and incidence

rates. Incidence studies were not available from developing countries.

There is a significant difference of prevalence estimates between

northern European and American countries and developing countries.

South European countries have lower median incidence rates than North

American and north European countries. As concerning the time trends

of RA occurrence, only 3 incidence studies provided secular data from

the same study area, based on ACR criteria, using the same methods of

case ascertainment. Two of these studies indicate a decreasing

incidence of RA in Finland and United States of America.

CONCLUSIONS: The occurrence of RA varies among countries and areas of

the world. A decreasing trend has been observed in countries

characterized by high rates of RA incidence and prevalence. However,

the relatively small number of studies for most areas of the world and

the lack of incidence studies for the developing countries limits the

understanding of worldwide RA epidemiology.

PMID: 17045630

http://www.ncbi.nlm.nih.gov/pubmed/17045630

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