POS1427 NATIONAL BURDEN OF RHEUMATOID ARTHRITIS IN CANADA 1990-2017: FINDINGS FROM THE GLOBAL BURDEN OF DISEASE STUDY 2017
Authors: N. Hassen, D. Lacaille, A. Xu, S. Sidi, A. Alandejani, M. Mansourian, N. Sarrazadegan, J. Kopec
Journal: Annals of the Rheumatic Diseases (2021)

Background: According to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, over 120,000 individuals currently have rheumatoid arthritis (RA) in Canada, yet a study that evaluates the combined effect of RA on the longevity and quality of life in the country is lacking. Objectives: The objectives of this study are three: 1) to describe burden of RA levels and trends from 1990-2017 using GBD data, 2) to describe age and sex differences, and 3) to compare Canada RA burden to other countries. Methods: We obtained publicly available data from GBD Study 2017 from the Institute for Health Metrics and Evaluation interactive visualization tool ( http://vizhub.healthdata.org/gbd-compare ). Disease burden indicators include prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Estimates were presented as non age-standardized and age-standardized rates per 100,000 population. GBD estimated prevalence using published literature, survey data, patient records, and health insurance claims, and mortality using cause of death ensemble modelling technique. YLLs measure premature death calculated as the sum of each death multiplied by the standard life expectancy at each age. YLDs measure amount of time in a year an individual lives with a short- or long-term health condition, calculated by combining prevalence with disability weights for each age/sex/year. DALYs were calculated as the sum of YLLs and YLDs. DALYs for Canada were compared to DALYs of countries with similar socio-demographic index (SDI) values. SDI combines income per capita, average educational attainment, and fertility rates. Data were analysed by DisMod-MR 2.1, a Bayesian meta-regression tool. Results: In Canada, RA mortality (mortality and YLLs) improved over time, with a steeper decline after the year 2002. However, the population burden of quality of life (YLDs and DALYs) increased due to increasing prevalence. The disease burden was higher in females (prevalence, mortality, YLLs, YLDs, DALYs), and DALY rates were higher among older populations. Compared to other countries, Canada had greater improvement in mortality and YLLs over time and had a lower age-standardized DALYs rate compared to countries of similar SDI values. A weak association was found between global age-standardized DALYs and SDI (R 2 = 0.0138). Conclusion: RA is a major public health challenge. Canada fares better than other countries with regards to national RA burden. Early identification and management are critical to reducing the overall burden of RA in Canada, especially in women. More data from multiple provincial RA databases would increase the accuracy of our estimates for Canada. References: [1]Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316-1322. doi:10.1136/annrheumdis-2013-204627 [2]Myasoedova E, Davis JM 3rd, Crowson CS, Gabriel SE. Epidemiology of rheumatoid arthritis: rheumatoid arthritis and mortality. Curr Rheumatol Rep. 2010;12(5):379-385. doi:10.1007/s11926-010-0117-y [3]Safiri S, Kolahi AA, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis. 2019;78(11):1463-1471. doi:10.1136/annrheumdis-2019-215920 Acknowledgements: Nejat Hassen is supported by a grant from the Canadian Institute of Health Research. Dr. Diane Lacaille is supported by the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. Disclosure of Interests: None declared