Here are other important communication points regarding RMDs, according to the group:
Diversity
Data suggest more than 200 RMDs exist—some very common and some rare. Symptomatic osteoarthritis affects 15% of people worldwide, according to a conservative United Nations estimate, and by 2050, 130 million will be affected, with 40 million severely disabled by it. Rheumatoid arthritis affects about one in 100 people around the world, with women twice as likely to be diagnosed. Other RMDs, such as systemic lupus erythematosus (SLE) are less common, but still cause significant morbidity and mortality.
In the U.S., the overall lifetime risk for developing an inflammatory RMD—including RA, gout and lupus—has been calculated as one in 12 for women and one in 20 for men.3
RMDs frequently affect joints, but also affect internal organs and the skin, and many of them occur in children, even though RMDs are commonly thought of as a disease of aging.
Pathophysiologic Pathways Vary
Many RMDs come about because of dysregulation and activation of immune mechanisms, leading to inflammation and tissue damage. But others stem from acute or chronic damage to musculoskeletal structures, such as bone and cartilage.
According to Dr. van der Heijde and her colleagues, other diseases with a primary cause that is metabolic, endocrine, neurologic or infectious can bring on secondary dysfunction of musculoskeletal tissue—for example, changes in tendon structure and other soft tissues caused by prolonged hyperglycemia in diabetes.
A Major Burden
Many RMDs start in childhood or early adulthood, so Dr. van der Heijde and her colleagues wrote, “patients suffer with their disease for decades. … Moreover, most RMDs worsen over time with increasing impact on both the physical and psychological conditions of the patient.”
A 17-country collaboration in Europe found musculoskeletal problems are the most common cause of severe long-term pain and disability in the European Union, with significant healthcare costs, and are a major cause of loss of work productivity.4
A recent U.S. study found that arthritis affects about 37% of the adult population—about 29% of men and 55% of women between 18 and 65.5 As the population ages, Dr. van der Heijde and her colleagues note, the prevalence of RMDs is only increasing.
In a report on global burden of disease, the World Health Organization listed osteoarthritis as the eighth-leading cause of impact on disability-adjusted life years (DALY), essentially the loss of one year of healthy life.6
For many RMDs, Dr. van der Heijde and her colleagues wrote, “it is important to recognize the disease early to have the best option to start treatment early and prevent or limit long-term consequences.”
‘It is important to understand what rheumatic diseases are [because] they are prevalent & lead to a major burden for both patients & society.’ —Desiree van der Heijde, MD, PhD
Workforce Issues
Dr. van der Heijde and her colleagues note that a range of practitioners—including general physicians, community pharmacists and medical specialists—manage musculoskeletal problems. Rheumatologists are the specialists that possess the broadest, most specific training for the diagnosis and management of RMDs.