Socioeconomic inequality in patients with rheumatoid arthritis: a systematic review and meta-analysis

Abstract

Background: Rheumatoid arthritis is a chronic inflammatory and systemic autoimmune disease associated with synovial fluid inflammatory lesions and articular changes. The aim of the present study was to determine socioeconomic inequality in RA patients using a meta-analysis approach. Methods: A systematic search of national and international databases of SID, MagIran, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) was conducted to find articles published from 1988 to March 2020. Random effects model was used for analysis and heterogeneity of studies was investigated using I2 index. Data analysis was then carried out using Comprehensive Meta-Analysis (Ver. 2). Results: A total of 51 articles with a total sample size of 48,195 individuals were included in the meta-analysis in all the components. The results showed that 18.9% (95% CI: 4.9–13.25%) of patients were single patients, 70.6% (95% CI: 63.5–76.8%) were married, 31.6% (95% CI: 24.5–39.7%) had low economic status, 52.1% (95% CI: 5.8–44.53%) had moderate economic status, level of education was below diploma in 33% (95% CI: 27.1–39.5%) of cases, 36.2% (95% CI: 27.3–46.1%) were smokers, and 8.8% (95% CI: 2.8–24.1%) of patients were unemployed. Conclusion: The results of the present study indicate high socioeconomic inequality in RA patients in the main components of the study. Hence, to improve the aforementioned status and find causes and do the monitoring at all levels, appropriate solutions must be adopted by providing feedback to policy-makers. Key Points: • The results showed that 18.9% (95% CI: 4.9–13.25%) of patients were single patients. • 70.6% (95% CI: 63.5–76.8%) were married and 31.6% (95% CI: 24.5–39.7%) had low economic status. • 52.1% (95% CI: 5.8–44.53%) had moderate economic status; 36.2% (95% CI: 27.3–46.1%) were smokers.