A snapshot of rheumatoid arthritis

Summary

• Rheumatoid arthritis is an autoimmune disease – one where the body’s immune system attacks its own tissues – and thus differs from osteoarthritis which is characterised by wear-and-tear of joints.
• Joints bear the brunt of autoimmunity in rheumatoid arthritis, the hallmark of the condition being painful swelling and stiffness in the joints. Rheumatoid arthritis, however, is a systemic condition, meaning that the whole body is affected. Organs and systems such as the heart, respiratory systems and digestive systems are also involved.
• According to the 2007–08 National Health Survey (NHS), an estimated 428,000 Australians reported having rheumatoid arthritis. With approximately 2% of the population affected, rheumatoid arthritis is the second most common type of arthritis, after osteoarthritis.
• Rheumatoid arthritis can develop at any age, but the condition is more common in those aged 55 and older. The condition is 1.6 times as common in women (2.4%) as in men (1.5%).
• The way rheumatoid arthritis is managed has changed over the past 10 years:
  • In 2003, a new class of medicine, referred to as biologic disease-modifying anti-rheumatic drugs (bDMARD), became available for treatment of rheumatoid arthritis in Australia, broadening the treatment options.
  • Hospital separations for the principal diagnosis of rheumatoid arthritis increased from 30 per 100,000 population in 2001–02 to 53 per 100,000 in 2010–11, with same-day admissions becoming more common than overnight admissions from 2005–06 onwards.
  • The number of times pharmacotherapy, such as corticosteroids and bDMARDs, was administered during admitted hospital care more than doubled from 2,608 in 2004–05 to 6,932 in 2010–11.
• Rheumatoid arthritis can be a significant cause of disability and have considerable impact on quality of life. According to the 2007–08 NHS, people with rheumatoid arthritis were:
  • 2.9 times as likely as those without the condition to report severe or very severe pain
  • 1.7 times as likely as those without the condition to report high or very high levels of psychological distress
  • 3.3 times as likely as those without the condition to report poor health status.
• The ways in which rheumatoid arthritis affects society include reduced workforce participation, increased costs of managing the condition, and increased impacts on carers.
  • In 2008–09, the estimated total direct health expenditure on rheumatoid arthritis was $318.7 million, a substantial share of it being accounted for by prescription medicines ($273.6 million or 86% of the total).
  • Currently, there are no national statistics on the indirect cost of managing rheumatoid arthritis, such as productivity loss and costs for carers.