ArticleClinical rheumatology2026
Sex-specific burden of osteoarthritis and rheumatoid arthritis across Asia, 1990-2023: a Global Burden of Disease Study 2023.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough the burden of osteoarthritis (OA) and rheumatoid arthritis (RA) varies widely across Asia and exhibits substantial differences by sex, comparative analyses of OA and RA with a focus on sex within this region remain scarce. Therefore, this study aimed to examine the burden of OA and RA across Asia with a particular emphasis on sex-related disparities.
methodsUsing data from the Global Burden of Disease Study 2023, we estimated the burden of OA and RA from 1990 to 2023 across 34 countries in Asia. OA was defined as symptomatic, radiographically confirmed osteoarthritis, and RA was defined according to the 1987 American College of Rheumatology classification criteria. Disease burden was measured using age-standardized prevalence and years lived with disability (YLD) rates per 100,000 population for overall OA, site-specific OA including hip, knee, hand, and other OA, and RA, along with corresponding 95% uncertainty intervals (UIs). Analyses primarily focused on sex-specific differences and were additionally stratified by age group.
resultsIn 2023, the highest age-standardized prevalence rate (ASPR) of OA was observed in high-income Asia Pacific (male: 6691.36 [95% UI, 6041.98-7417.59] per 100,000 population; female: 10,314.70 [9299.49-11,436.61]), with the most significant sex differences observed in Central Asia. The highest ASPR of RA was observed in East Asia among males (161.70 [141.02-188.40] per 100,000 population) and in high-income Asia Pacific among females (360.95 [317.88-410.81]), with the largest sex disparities occurring in high-income Asia Pacific. Between 1990 and 2023, the burden of OA increased slightly across all Asian regions, whereas the burden of RA increased in most regions, except among females in high-income Asia Pacific (total percent change, -0.14%). Females consistently presented a higher burden of OA and RA across all age groups compared to males, except for hip OA, which was more prevalent among males in most regions. Decomposition analyses identified population aging as the primary contributor to the increasing burden, with region-specific contributions from population growth and epidemiological change; notably, epidemiological change related to RA declined only among females in high-income Asia Pacific by 63.05% of the change.
conclusionsThis study highlights the significant regional and sex-specific variation in the burden of OA and RA across Asia. While population aging remains the primary driver of the increasing burden, the geographically diverse epidemiologic patterns underscore the need for sex-specific and country-tailored policy approaches. Key Points •OA and RA burden in Asia showed strong regional and sex variation in 2023. •East Asia had the highest case numbers, while high-income Asia Pacific had the highest rates. •Females consistently had a higher burden than males across all ages. •Population aging was the main driver, with regional differences and notable improvements in RA among high-income Asia Pacific females.
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