REVIEW - Incidence and prevalence of RA based on the 1987 ACR criteria: a systematic review

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

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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