Prevalence of rheumatoid arthritis in South America: a systematic review and meta-analysis

Germano, Jaqueline L.; Reis-Pardal, Joana; Tonin, Fernanda S.; Pontarolo, Roberto; Melchiors, Ana C.; Fernandez-Llimos, Fernando

doi:10.1590/1413-812320212611.3.05152020

Jaqueline L. Germano

Secretaria de Estado da Saúde do Paraná. R. Piquiri 170, Rebouças. 80230-140 Curitiba PR Brasil. jaque_lg@hotmail.com

Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Paraná (UFPR). Curitiba PR Brasil.

https://orcid.org/0000-0003-4813-0675

Joana Reis-Pardal

Departamento de Farmácia, Hospital de Sant’Ana, Santa Casa da Misericórdia de Lisboa. Parede Portugal.

https://orcid.org/0000-0002-0314-8233

Fernanda S. Tonin

Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Paraná (UFPR). Curitiba PR Brasil.

https://orcid.org/0000-0003-4262-8608

Roberto Pontarolo

Departamento de Farmácia, UFPR. Curitiba PR Brasil.

https://orcid.org/0000-0002-7049-4363

Ana C. Melchiors

Departamento de Farmácia, UFPR. Curitiba PR Brasil.

https://orcid.org/0000-0002-8538-2903

Fernando Fernandez-Llimos

Laboratório de Farmacologia, Faculdade de Fármacia, Universidade do Porto. Porto Portugal.

https://orcid.org/0000-0002-8529-9595

Collaborations

J Reis-Pardal, FS Tonin, R Pontarolo, AC Melchiors and F Fernandez-Llimos participated in conceptualization. JL Germano and J Reis-Pardal participated in data curation. JL Germano, J Reis-Pardal and FS Tonin participated in formal analysis and investigation. R Pontarolo was responsible for funding acquisition. J Reis-Pardal, FS Tonin and F Fernandez-Llimos designed the methodology. AC Melchiors and F Fernandez-Llimos participated in project administration and supervision. FS Tonin and F Fernandez-Llimos participated in validation. All the authors participated in writing, review and editing.

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Study	Type of document	Country	Ethnicity	Study period	RA definition	Data source
Caturegli and Caturegli, 2016³⁰30 Caturegli G, Caturegli P. Disease prevalence in a rural Andean population of central Peru: a focus on autoimmune and allergic diseases. Auto Immun Highlights 2016; 7(1):3.	Journal article	Peru	Amerindian	2015	-	Clinical registries
Di et al., 2016²⁷27 Di WT, Vergara F, Bertiller E, Gallardo ML, Gandino I, Scolnik M, Martinez MJ, Schpilberg MG, Rosa J, Soriano ER. Incidence and Prevalence of Rheumatoid Arthritis in a Health Management Organization in Argentina: A 15-year Study. J Rheumatol 2016; 43(7):1306-1311.	Journal article	Argentina	All	2015	2010 ACR/EULAR criteria	Capture-recapture
Díaz-Rojas et al., 2016³¹31 Díaz-Rojas JA, Dávila-Ramírez FA, Quintana-López G, Aristizábal-Gutiérrez F, Brown P. Prevalencia de artritis reumatoide en Colombia: una aproximación basada en la carga de la enfermedad durante el año 2005. Rev Colomb Reumatol 2016; 23(1):11-16.	Journal article	Colombia	All	2005	ICD-10	Clinical registries
Fernández-Ávila et al., 2019⁴⁰40 Fernández-Ávila DG, Rincón-Riaño DN, Bernal-Macías S, Gutiérrez Dávila JM, Rosselli D. Prevalencia de la artritis reumatoide en Colombia según información del Sistema Integral de Información de la Protección Social. Rev Colomb Reumatol 2019; 26(2):83-87.	Journal article	Colombia	All	2012-2016	ICD-10	Clinical registries
Franco et al., 2016³²32 Franco M, Avila Pedretti G, Morel Z, Cabrera-Villalba S, Melgarejo P, Elizaur JG, Albrecht TR, Paredes E, Mazzoleni J. Frecuencia de artritis reumatoide en el hospital central de IPS. Análisis preliminar. Rev Parag Reumatol 2016; 2(2):62-66.	Journal article	Paraguay	All	2015	ICD-10	Clinical registries
Gamboa et al., 2009²³23 Gamboa R, Medina M, Acevedo E, Pastor C, Cucho J, Gutiérrez C, Ugarte M, Sánchez C, Perich R, Alfaro J, Sánchez A, La Madrid K, Zevallos F. Prevalencia de enfermedades reumatologicas y discapacidad en una comunidad urbano-marginal: resultados del primer estudio COPCORD en el Perú. Rev Peru Reumatol 2009; 15(1):40-46.	Journal article	Peru	All	2004	ACR 1987 revised criteria	COPCORD*
Granados et al., 2015²⁵25 Granados Y, Cedeno L, Rosillo C, Berbin S, Azocar M, Molina ME, Lara O, Sanchez G, Peláez-Ballestas I. Prevalence of musculoskeletal disorders and rheumatic diseases in an urban community in Monagas State, Venezuela: a COPCORD study. Clin Rheumatol 2015; 34(5):871-877.	Journal article	Venezuela	All	2011	ACR 1987 revised criteria	COPCORD*
Granados et al., 2016²⁹29 Granados Y, Rosillo C, Cedeno L, Martinez Y, Sanchez G, Lopez G, Pérez F, Martínez D, Maestre G, Berbin S, Chacón R, Stekman I, Valls E, Peláez-Ballestas I. Prevalence of musculoskeletal disorders and rheumatic disease in the Warao, Kari'na, and Chaima indigenous populations of Monagas State, Venezuela. Clin Rheumatol 2016; 35(Supl. 1):53-61.	Journal article	Venezuela	Indigenous	-	ACR 1987 revised criteria	COPCORD*
Guevara-Pacheco et al., 2016²⁸28 Guevara-Pacheco S, Feican-Alvarado A, Sanin LH, Vintimilla-Ugalde J, Vintimilla-Moscoso F, Delgado-Pauta J, Lliguisaca-Segarra A, Dután-Erráez H, Guevara-Mosquera D, Ochoa-Robles V, Cardiel MH, Peláez-Ballestas I. Prevalence of musculoskeletal disorders and rheumatic diseases in Cuenca, Ecuador: a WHO-ILAR COPCORD study. Rheumatol Int 2016; 36(9):1195-1204.	Journal article	Ecuador	All	2014	ACR 1987 revised criteria	COPCORD*
Anaya et al., 2001¹¹11 Anaya JM, Correa PA, Mantilla RD, Jimenez F, Kuffner T, McNicholl JM. Rheumatoid arthritis in African Colombians from Quibdo. Semin Arthritis Rheum 2001; 31(3):191-198.	Journal article	Colombia	African Colombian	1996	ACR 1987 revised criteria	Clinical registries
Londoño et al., 2018³⁸38 Londoño J, Peláez Ballestas I, Cuervo F, Angarita I, Giraldo R, Rueda JC, Ballesterosa JG, Baqueroa R, Foreroc E, Cardield M, Saldarriagaa E, Vásqueza A, Ariasa S, Valeroa L, Gonzáleza C, Ramíreze J, Toroe C, Santos AM. Prevalencia de la enfermedad reumática en Colombia, según estrategia COPCORD-Asociación Colombiana de Reumatología. Estudio de prevalencia de enfermedad reumática en población colombiana mayor de 18 años. Rev Colomb Reumatol 2018; 25(4):245-256.	Journal article	Colombia	All	2014	ACR criteria	COPCORD*
Machado-Alba et al., 2015²⁶26 Machado-Alba JE, Ruiz AF, Medina Morales DA. The epidemiology of rheumatoid arthritis in a cohort of Colombian patients. Rev Colomb Reumatol 2015; 22(3):148-152.	Journal article	Colombia	All	2009-2013	ICD-10	Clinical registries
Mestanza-Peralta et al., 2006²²22 Mestanza-Peralta M, Zurita-Salinas C, Armijos R. Prevalence of rheumatic diseases in a rural community in Ecuador. A community oriented program for control of rheumatic disorders (COPCORD). J Clin Rheumatol 2006; 12(Supl. 4):S6.	Conference abstract	Ecuador	All	-	-	COPCORD*
Medina et al., 2006²¹21 Medina M, Acevedo-Vasquez E, Gutierrez C, Perich R, Sanchez-Torres A, De Leon DP, Pastor-Asurza C, Gamboa R, Alfaro J, Cucho M, Sanchez-Schwartz C. Low prevalence of rheumatoid arthritis in an urban mestizo population. J Clin Rheumatol 2006; 12(Supl. 4):S5.	Conference abstract	Peru	Mestizo	2004	-	Clinical registries
Fabiani Muñoz,2006²⁰20 Fabiani Muñoz IA. Prevalencia de Patología Músculo-esquelética Reumatoidea en el CESFAM "Cristo Vive", Santiago 2004. Santiago: Universidad de Chile; 2006.	Thesis	Chile	All	2004	ICD-10	Clinical registries
Palmezano-Díaz et al., 2018³⁹39 Palmezano-Díaz JM, Figueroa-Pineda CL, Rodríguez-Amaya RM, Plazas-Rey LK. Prevalencia y caracterización de las enfermedades autoinmunitarias en pacientes mayores de 13 años en un hospital de Colombia. Med Int Mex 2018; 34(4):522-535.	Journal article	Colombia	All	2012-2016	ICD-10	Clinical registries
Peláez-Ballestas et al., 2018³⁵35 Pelaez-Ballestas I, Granados Y, Quintana R, Loyola-Sanchez A, Julian-Santiago F, Rosillo C, Gastelum-Strozzi A, Alvarez-Nemegyei J, Santana N, Silvestre A, Pacheco-Tena C, Goñi M, García-García C, Cedeño L, Pons-Éstel BA, Latin American Study Group of Rheumatic Diseases in Indigenous Peoples (GLADERPO). Epidemiology and socioeconomic impact of the rheumatic diseases on indigenous people: an invisible syndemic public health problem. Ann Rheum Dis 2018; 77(10):1397-1404.	Journal article	Argentina	Qom	2011-2015	ACR 1987 revised criteria	COPCORD*
		Venezuela	Warao
		Venezuela	Chaima
Quintana et al., 2018³⁶36 Quintana R, Goni M, Mathern N, Jorfen M, Conti S, Nieto R, Sanabria A, Prigione C, Silvestre AMR, García V, Pons-Estel G, Cervera R, García C, Peláez-Ballestas I, Alarcón GS, Pons-Estel BA. Rheumatoid arthritis in the indigenous qom population of Rosario, Argentina: aggressive and disabling disease with inadequate adherence to treatment in a community-based cohort study. Clin Rheumatol 2018; 37(9):2323-2330.	Journal article	Argentina	Indigenous	-	ACR 1987 revised criteria	COPCORD*
FCEAC, 2017³³33 Cuenta de Alto Costo. Situacion de la artritis reumatoide en Colombia 2016. Bogota: CAC; 2017.	Book	Colombia	All	2015-2016	ICD-10	Clinical registries
Scublinsky et al, 2010²⁴24 Scublinsky D, Venarotti H, Citera G, Messina OD, Scheines E, Rillo O, Arturi A, Hofman J, Somma LF, Casado G, Iannantuono RF, Gonzalez CD. The prevalence of rheumatoid arthritis in Argentina: a capture-recapture study in a city of Buenos Aires province. J Clin Rheumatol 2010; 16(7):317-321.	Journal article	Argentina	All	2008	ACR 1987 revised criteria	Capture-recapture
Senna et al., 2004¹⁹19 Senna ER, Barros AL, Silva EO, Costa IF, Pereira LV, Ciconelli RM, Ferraz MB. Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach. J Rheumatol 2004; 31(3):594-597.	Journal article	Brazil	All	-	ACR 1987 revised criteria	COPCORD*
Soriano et al., 2003¹⁸18 Soriano ER, Carrio JH, Schpilberg M, Figar S, Imamura PM, Catoggio LJ. Incidence and prevalence of rheumatoid arthritis (RA) in a health management organization (HMO) in Argentina. Rheumatology (Oxford) 2003; 42(Supl. 1):127-131.	Conference abstract	Argentina	All	2002	ACR 1987 revised criteria	Clinical registries
Spindler et al., 2002¹⁷17 Spindler A, Bellomio V, Berman A, Lucero E, Baigorria M, Paz S, Garrone N, Torres AI, Romano O, Carraccio A, Leal O, Bazzano A, Vazquez D, Pera O, Arquez G, Valdez M, Lazaro H, Rengel S, Acosta E, Santana M. Prevalence of rheumatoid arthritis in Tucuman, Argentina. J Rheumatol 2002; 29(6):1166-1170.	Journal article	Argentina	All	1998-1999	ACR 1987 revised criteria	Clinical registries
Tolentino, 2017³⁴34 Tolentino DSJ. Estudo da prevalência de doenças autoimunes na microrregião de saúde de Águas Formosas - Minas Gerais - Brasil [dissertação]. Teófilo Otoni: Universidade Federal dos Vales do Jequitinhonha e Mucuri; 2017.	Thesis	Brazil	All	2016	-	Clinical registries
Vega-Hinojosa et al., 2017³⁷37 Vega-Hinojosa O, Cardiel MH, Ochoa-Miranda P. Prevalence of musculoskeletal manifestations and related disabilities in a Peruvian urban population living at high altitude. COPCORD Study. Stage I. Reumatol Clin 2018; 14(5):278-284.	Journal article	Peru	All	2010	ACR 1987 revised criteria	COPCORD*

		Studies (N)	Event rate	95%CI	I2	P-value*
Subgroup by country
	Argentina	6	0.59%	0.32%-1.10%	99%	<0.001
	Brazil	2	0.22%	0.05%-0.91%	95%
	Chile**	1	0.56%	0.29%-1.08%	-
	Colombia	7	0.24%	0.15%-0.39%	99%
	Ecuador	2	0.89%	0.69%-1.16%	0%
	Paraguay**	1	2.40%	2.22%-2.58%	-
	Peru	4	0.55%	0.27%-1.11%	89%
	Venezuela	4	0.86%	0.41%-1.77%	83%
Subgroup by ethnicity
	All population	19	0.44%	0.33%-0.58%	99%	<0.001
	African**	1	0.20%	0.10%-0.30%	-
	Indigenous	6	1.45%	0.88%-2.37%	85%
	Mestizo**	1	0.32%	0.31%-0.33%	-
Subgroup by data source
	Clinical registries	13	0.26%	0.18%-0.37%	99%	<0.001
	COPCORD***	12	1.07%	0.74%-1.55%	90%
	Capture-recapture	2	0.35%	0.30%-0.41%	68%

Country	Clinical registries			COPCORD
Country	Studies (N)	Event rate [95%CI]	I2	Studies (N)	Event rate [95%CI]	I2
Argentina	2	0.21% [0.18%-0.25%]	75%	2	2.76% [2.22%-3.34%]	20%
Brazil	1*	0.11% [0.08%-0.14%]	-	2	0.46% [0.27%-0.78%]	0%
Chile	1*	0.56% [0.29%-1.08%]	-	-	-	-
Colombia	6	0.18% [0.11%-0.30%]	99%	1*	0.15% [0.12%-0.18%]	-
Ecuador	-	-	-	2	0.89% [0.69%-0.12%]	0%
Paraguay	1*	2.40% [2.22%-2.58%]	-	-	-	-
Peru	2	0.32% [0.31%-0.33%]	0%	2	0.82% [0.33%-2.01%]	80%
Venezuela	-	-	-	4	0.86% [0.41%-1.76%]	83%

[1] Collaborations

J Reis-Pardal, FS Tonin, R Pontarolo, AC Melchiors and F Fernandez-Llimos participated in conceptualization. JL Germano and J Reis-Pardal participated in data curation. JL Germano, J Reis-Pardal and FS Tonin participated in formal analysis and investigation. R Pontarolo was responsible for funding acquisition. J Reis-Pardal, FS Tonin and F Fernandez-Llimos designed the methodology. AC Melchiors and F Fernandez-Llimos participated in project administration and supervision. FS Tonin and F Fernandez-Llimos participated in validation. All the authors participated in writing, review and editing.

Brasil

Brasil

Prevalence of rheumatoid arthritis in South America: a systematic review and meta-analysis

Prevalência da artrite reumatoide na América do Sul: revisão sistemática e meta-análise

Abstract