Epidemiological assessment of six major immune-mediated inflammatory diseases based on the Global Burden of Disease Study 2021: analyses of age-standardized incidence, prevalence, mortality, and disability-adjusted life years
Mengyu Huang, Zhengqing Ma, X. Luo, Qian Ren
Abstract
Immune-mediated inflammatory diseases (IMIDs) are a group of chronic conditions characterized by dysregulated immune responses and tissue inflammation, posing a significant challenge to global health. However, comprehensive epidemiological analysis of the burden of these diseases remains limited. This study aimed to assess the trends in disease burden of six major IMIDs from 1990 to 2021 using the Global Burden of Disease (GBD) 2021 data, providing evidence for targeted prevention and control strategies. Methods: Utilizing GBD 2021 data, we analyzed the epidemiological trends in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized death rate (ASDR), and disability-adjusted life years (DALYs) for six IMIDs across global, 21 regions, 5 Socio-demographic Index (SDI) quintiles, and 204 countries and territories. Joinpoint regression analysis was employed to evaluate temporal trends, calculating the average annual percentage change (AAPC) and its 95% confidence interval (CI). From 1990 to 2021, global ASIR, ASPR, ASDR, and DALYs for asthma, atopic dermatitis (AD), and multiple sclerosis (MS) exhibited declining trends. In contrast, ASIR, ASPR, and DALYs for psoriasis (PsO) showed a comprehensive increasing trend. For inflammatory bowel disease (IBD) and rheumatoid arthritis (RA), ASIR increased significantly, while ASDR and DALYs decreased. Furthermore, significant regional heterogeneity in disease burden was observed: high-SDI regions typically demonstrated higher ASIR and ASPR but lower ASDR; conversely, low-SDI regions exhibited lower ASIR and ASPR alongside higher ASDR. Despite significant spatiotemporal heterogeneity in the burden of the six IMIDs at global and regional levels, they collectively impose a substantial health burden worldwide. Consequently, future efforts require region-specific, differentiated public health interventions to address the ongoing challenge posed by IMIDs to global health systems. • Global ASIR of asthma, AD, and MS declined, while IBD, PsO, and RA ASIR increased from 1990 to 2021. • High-SDI regions reported the highest incidence, whereas low-SDI regions faced the highest mortality. • Stable median onset age and HAQ-based analysis suggest diagnostic capacity, not criteria changes, drove incidence trends. • Findings underscore the urgent need for region-specific public health strategies to mitigate the growing global burden of IMIDs.