Global Trends Informing the Future of Rheumatoid Arthritis Save

Finkh et al report on the prevalence and interesting trends in rheumatoid arthritis (RA), including its higher prevalence in industrialized countries and declining disease severity over time. 

The article appears in Nature Reviews Rheumatology and discusses worldwide variance in prevalence (which generally appears to be increasing) and severity are rooted in genetic factors, under-reporting, and improved care afforded by drug developent and evolving treatment paradigms.

While the prevalence of RA is rising, the severity, mortality and disease-associated comorbidities seem to be decreasing.

They speculate on the ‘mucosal origin’ hypothesis underlying the etiopathogenesis of RA, and as such, we will need to focus on genetic factors, environmental triggers, mucosal and microbiome immunity in the lungs, GI tract and oral cavity.

If the ‘mucosal origin’ hypothesis holds water then there will need to be a greater role for modifiable risk factors (e.g., dietary habits, dental care, pollutants, and tobacco) in future prevention strategies.