Analysis of the burden of rheumatoid arthritis in BRICS countries and globally from 1990 to 2021 and projections of future trends to 2036: Insights from the global burden of disease study 2021.

Abstract

This study aims to evaluate the global and BRICS-specific burden of rheumatoid arthritis (RA) from 1990 to 2021, analyzing temporal trends in incidence, prevalence, and disability-adjusted life years (DALYs), as well as projecting future disease burden to 2035. Data were obtained from the Global Burden of Disease (GBD) 2021 database. Age-standardized incidence rate (ASIR), prevalence rate (ASPR), and DALY rate (ASDR) were assessed globally and across BRICS countries using Joinpoint regression to estimate average annual percent change (AAPC). Subgroup analyses were conducted by age, sex, and region, with projections modeled to 2035. From 1990 to 2021, global RA incidence and prevalence exhibited significant upward trends (ASIR: 10.42 to 11.8 per 100,000; ASPR: 182.54 to 208.9 per 100,000). The global ASDR remained relatively stable (36.42-35.89 per 100,000). Among BRICS nations, India demonstrated the steepest rise in both ASIR and ASPR, while South Africa experienced declines in both prevalence and DALY rates. Females consistently bore a higher RA burden across all age groups. Burden projections to 2035 indicate continued increases in ASIR and ASPR globally and in most BRICS nations, whereas ASDR is expected to remain stable or decline. RA remains a major public health challenge worldwide, with substantial heterogeneity across BRICS countries. Differences are largely driven by demographic aging, environmental exposures, lifestyle risk factors (e.g., smoking, obesity), and disparities in healthcare access. Targeted prevention, strengthened primary care, and equitable health resource allocation are essential to mitigate the rising RA burden, particularly in emerging economies.