The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases

Abstract

Objective: Understanding of the personal risks for rheumatoid arthritis (RA) and other rheumatic diseases remains poor, despite advances in knowledge with regard to their pathogenesis, therapeutics, and clinical impact, in part because the personal lifetime risk of developing these diseases is unknown. This study was undertaken to estimate the lifetime risk of RA, as well as other inflammatory autoimmune rheumatic diseases, including systemic lupus erythematosus, psoriatic arthritis, polymyalgia rheumatica (PMR), giant cell arteritis, ankylosing spondylitis, and Sjögren's syndrome, and to provide an overall estimate of the risk of developing inflammatory autoimmune rheumatic disease over a lifetime.

Methods: Using the incidence rates obtained from our population-based studies of rheumatic diseases among residents of Olmsted County, Minnesota, and mortality rates from life tables for the general population, we estimated the sex-specific lifetime risk of rheumatic disease.

Results: The lifetime risk of RA developing in US adults was 3.6% for women and 1.7% for men, and the lifetime risk of rheumatoid factor-positive RA was 2.4% for women and 1.1% for men. The second most common inflammatory autoimmune rheumatic disease was PMR, with a lifetime risk of 2.4% for women and 1.7% for men. The overall lifetime risk of inflammatory autoimmune rheumatic disease was 8.4% for women and 5.1% for men.

Conclusion: One in 12 women and 1 in 20 men will develop an inflammatory autoimmune rheumatic disease during their lifetime. These results can serve as useful guides in counseling patients regarding their lifetime risk of these conditions and have important implications regarding disease awareness campaigns.

Figures

Figure 1

Cumulative lifetime risk of rheumatoid arthritis for women and men.

Figure 2

Residual lifetime risk of rheumatoid arthritis for women (top panel) and men (bottom panel) without rheumatoid arthritis at ages 30, 40, 50, 60, 70, and 80 years.

Figure 3

Incidence rates for women (top panel) and men (bottom panel) according to age for rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases (solid black: primary autoimmune inflammatory rheumatic disease; red: rheumatoid arthritis; blue: systemic lupus erythematosus; green: psoriatic arthritis; cyan: polymyalgia rheumatica; magenta: giant cell arteritis; dashed: ankylosing spondylitis; grey: Sjögrens syndrome).