EPIDEMIOLOGY

General

Prevalence of Joint Pain

Age-sex adjusted to the 2000 United States (US) standard population.Source: National Health Interview Survey (NHIS) 2007.Pfizer Medical Division. The Burden of Pain Among Adults in the United States. Pfizer Inc.; New York, NY: 2008.

47

37

15

31

39

31

15

26

44

34

15

28

0 10 20 30 40 50

65+

40–64

20–39

Total

Percent of adults

Age

rang

e (y

ears

)

Total

Men

Women

Prevalence of joint pain increases with age and is higher in women.

Prevalence of Joint Pain in Men

Source: National Health Interview Survey (NHIS) 2007.Pfizer Medical Division. The Burden of Pain Among Adults in the United States. Pfizer Inc.; New York, NY: 2008.

ShoulderTotal 8

20–39 4

40–64 10

65+ 11

WristTotal 4

20–39 2

40–64 5

65+ 6

HipTotal 4

20–39 1

40–64 5

65+ 9

AnkleTotal 5

20–39 4

40–64 6

65+ 6

ElbowTotal 4

20–39 2

40–64 6

65+ 4

FingersTotal 5

20–39 2

40–64 6

65+ 9

KneeTotal 15

20–39 8

40–64 18

65+ 23

ToesTotal 2

20–39 1

40–64 3

65+ 3

Percent

• Pain differs by site and age

Prevalence of Joint Pain in Women

ShoulderTotal 9

20–39 3

40–64 11

65+ 15

WristTotal 6

20–39 3

40–64 8

65+ 8

HipTotal 9

20–39 3

40–64 11

65+ 14

AnkleTotal 7

20–39 4

40–64 8

65+ 8

ElbowTotal 4

20–39 2

40–64 6

65+ 4

FingersTotal 5

20–39 2

40–64 6

65+ 9

KneeTotal 15

20–39 8

40–64 18

65+ 23

ToesTotal 2

20–39 1

40–64 3

65+ 3

National Health Interview Survey (NHIS) 2007.Pfizer Medical Division. The Burden of Pain Among Adults in the United States. Pfizer Inc.; New York, NY: 2008.

Percent

• Pain differs by site and age

• 49.9 million (22.2%) with self-reported, physician-diagnosed arthritis1†

• 21.1 million (9.4%) with arthritis and arthritis-attributable activity limitation1

• Affects more women than men in every age group2

Arthritis is Prevalent inAmerican Adults*

*Data sources: 2007–2009 data from the National Health Interview Survey (NHIS); †Includes multiple forms of arthritis; US = United States1. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2010; 59(39):1261-65; 2. Centers for Disease Control and Prevention. NHIS Arthritis Surveillance: Arthritis Prevalence in Women and Men. Available at: www.cdc.gov/arthritis/data_statistics/national_nhis.htm. Accessed: January 12, 2011; 3. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 2009; 58(16):421-6; 4. Hootman JM, Helmick CG. Arthritis Rheum 2006; 54(1):226-9.

0

20

40

60

80

100

18–24 25–34 35–44 45–54 55–64 65–74 75–84 85+

Perc

enta

ge o

f adu

lts

Age group (years)

Women Men

• Arthritis and rheumatism are leading causes of disability in the US3

• By 2030, a projected 67 million in the US will have health care practitioner-diagnosed arthritis4

Arthritis Is Commonly Reported*

*United States prevalence and trends dataPercentage = weighted percentageCenters for Disease Control and Prevention. About the Behavioral Risk Factor Surveillance System (BRFSS). Available at: http://www.cdc.gov/brfss/about/about_brfss.htm. Accessed: August 2, 2013; Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Annual Survey Data. Available at: http://www.cdc.gov/brfss/annual_data/annual_data.htm. Accessed: August 2, 2013.

Prevalence of Specific Conditions Associated with Chronic Joint Pain

Mayo Clinic. Arthritis. Available at: https://healthletter.mayoclinic.com/secure/pdf/SRAR.pdf. Accessed: August 19, 2013; Wong R et al. Prevalence of Arthritis and Rheumatic Diseases Around the World: A Growing Burden and Implications for Health Care Needs. Arthritis Community Research and Evaluation Unit; Toronto, ON: 2010.

Ankylosing Spondylitis

• May affect >400,000 Americans• Estimated prevalence in Caucasian populations:

~0.1–0.9%• Most common comorbidities are inflammatory

bowel disease and osteoporosis• Heredity is a major risk factor for ankylosing

spondylitis– HLA-B27 allele is found in 90% of patients with the disease

• Appears to contribute 16–50% of the genetic risk

HLA = human leukocyte antigenAmerican College of Rheumatology. AS Fact Sheet. Available at: http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Spondylarthritis_(Spondylarthropathy)/. Accessed: September 1, 2013;Kataria RK et al. Am Fam Physician 2004; 69(12):2853-60; Sieper J et al. Ann Rheum Dis 2002; 61(Suppl 3):iii8-18.

AS

WHO = World Health OrganizationSymmons D et al. The Global Burden of Rheumatoid Arthritis in the Year 2000. Available at: http://www.who.int/healthinfo/statistics/bod_rheumatoidarthritis.pdf. Accessed: September 1, 2013.

0

100

200

300

400

500

600

Africa(subregion D)

EasternMediterannean

(subregion B)

World

WHO subregion

Prev

alen

ce (p

er 1

00,0

00)

Males Females

Africa(subregion E)

EasternMediterannean

(subregion D)

Prevalence of Rheumatoid ArthritisRA

Osteoarthritis: Most Common Form of Chronic Joint Pain

• Affects:– 13.9% of adults aged 25 years and older– 33.6% of those 65 years and older

• As the general population ages, the numbers of people affected are likely to increase dramatically

Centers for Disease Control. Arthritis-Related Statistics. Available at: http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm. Accessed: July 19, 2013.

OA

Incidence of Osteoarthritis of the Hand, Hip and Knee

Oliveria SA et al. Arthritis Rheum 1995; 38(8):1134-41.

1200

1000

800

600

400

200

020–29 30–39 40–49 50–59 60–69 70–79 80–89

Age group (years)

Inci

denc

e ra

te p

er 1

00,0

00 p

erso

n-ye

ars Hand males

Hand femalesHip malesHip femalesKnee malesKnee females

OA

Commonly Affected Joints: Prevalence of Symptomatic Osteoarthritis

Hand: 8% of those ≥60 years

Foot: 2% of those 15–74 years

Knee: 12% ofthose ≥60 years

Hip: 4% ofthose ≥55 years

CMC = carpometacarpal; DlP = distal interphalangeal; MTP = metatarsophalangeal; PlP = proximal interphaIangeaICenters for Disease Control. Osteoarthritis. Available at: http://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Accessed: July 22, 2013.

OA

Summary

Epidemiology of Chronic Joint Pain: Summary

• The prevalence of joint pain increases with age and is higher in women

• Osteoarthritis is the most common form of chronic joint pain, affecting one-third of adults aged 65 years and older– Prevalence is expected to increase as the general

population ages

• Rheumatoid arthritis and ankylosing spondylitis may affect up to 4% and 1% of the population, respectively