Rheumatic diseases don’t come from a single cause — they arise from a mix of genetic risk and environmental triggers that interact in complex ways. In recent years, researchers have begun uncovering how factors like air pollution, diet, infections, and even where you live can influence who develops conditions such as rheumatoid arthritis, lupus, or scleroderma. Here are seven recent studies I want to highlight from the 2025 American College of Rheumatology Convergence that explore how genes and the environment work together to shape risk, disease progression, and outcomes in rheumatic diseases — and what this growing field of research could mean for prevention and early detection in the future.
This research looked at people who were experiencing joint pain (arthralgia) and asked: does having a family history of Rheumatoid arthritis (RA) affect what happens next? They found that individuals with a first-degree relative (parent, sibling, child) who has RA were at higher risk of progressing from joint pain to RA itself. In other words: family history matters. It suggests that when someone with arthralgia also has a close relative with RA, clinicians and patient-advocates should pay extra attention: more careful monitoring, earlier discussions about potential warning signs, and possibly earlier intervention. Since family history reflects both genetics and shared environment/lifestyle, the finding underlines that risk goes beyond just what you can test in the lab.
Researchers examined how genetic predisposition and exposure to air pollutants together affect the risk of developing Rheumatoid Arthritis (RA) in a large U.S. dataset. They found that having a higher genetic risk score (based on 92 known RA-related gene variants) significantly increased RA risk. On top of that, certain air pollutants—especially lead and fine particulate matter (PM2.5)—were strongly linked with higher RA risk. When they combined genetic and environmental data, their prediction of who might develop RA improved substantially versus using genetics alone. This suggests that for RA, genes and environment both matter—and integrating both gives a fuller picture of risk.
This study looked at people with Rheumatoid Arthritis (RA) to see if genetics that make someone more sensitive to pain affects their disease scores over time. They found that people with higher genetic risk for pain tended to report higher disease activity, especially in measures that rely on patient feedback, like tender joints or overall well-being. Objective measures like swollen joints or lab tests weren’t affected. This suggests that some people’s RA scores may be influenced by how strongly they feel pain, not just by inflammation.
Researchers looked at over 2,900 people with Rheumatoid Arthritis (RA) to see how being frail—and being male or female—affected the risk of death. They found that men had a higher risk of death than women overall, regardless of frailty status. However, when women became frail, their relative increase in risk compared to non‑frail men was larger than the comparable increase in men. In other words: men tend to have worse survival in RA, but frailty may hit women particularly hard in terms of added risk. The study suggests paying close attention to frailty especially in women with RA.
This study looked at people with Rheumatoid Arthritis (RA) in South Korea and compared their symptoms to air pollution levels. They found that when pollution—especially tiny particles in the air—was higher, RA symptoms got worse and flare‑ups were more common. In short, air pollution may make RA harder to manage.
This study surveyed 155 people in the U.S. living with autoimmune and rheumatic diseases to understand how extreme weather events — like wildfires, floods, and major storms — affect their health. More than half of participants reported a disease flare within three months of a severe weather event, especially those with rheumatoid arthritis or polymyalgia rheumatica. The risk was higher for people who couldn’t store medications properly during power outages and for Black respondents, suggesting both social and environmental vulnerabilities play a role. The findings highlight that climate disasters can directly worsen disease activity and access to care for people with chronic autoimmune conditions.
Researchers looked at data on people in the U.S. who died from Rheumatoid arthritis (RA) between 2011 and 2015 and compared this with a county-level “Environmental Quality Index” (EQI) that measures how unhealthy or healthy different places are (in terms of air, water, land, built environment and socioeconomic conditions). They found that overall environmental quality (the full EQI) didn’t show a strong link with RA deaths, but certain parts of the environment did: poorer water quality, worse land conditions, and worse socioeconomic environments were tied to higher odds of RA-related death. Interestingly, worse air quality and built environment were associated with lower odds of RA death in their data. They also found that these patterns varied by how urban or rural a place is and by race/ethnicity. The takeaway: environment and social conditions may matter for RA outcomes, but the relationships are complex and vary across communities.
