The prevalence of RA varies from 0.5 to 1.5 percent of the population in Western countries and affects more women than men (ratio 2.5:1).7 The annual incidence in women is estimated at 36/1,00,000 and in men 14/1,00,000, with the peak age of onset being between 30 and 55 years.8

Family studies demonstrate a modest genetic predisposition to the development of the disease. The concordance rate for monozygotic twins is about 25 percent, whereas fraternal twins and first-degree relatives of RA patients have a four-fold higher risk (2-5 percent) than the general population. HLA-DR4 and DR1 molecules are associated with an increased severity of the disease.9

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