Svensson John, Arkema Elizabeth V, Lundberg Ingrid E, Holmqvist Marie
Rheumatology Unit.
Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm.
Rheumatology (Oxford). 2017 May 1;56(5):802-810. doi: 10.1093/rheumatology/kew503.
To estimate the incidence rate and prevalence of idiopathic inflammatory myopathies (IIMs) in Sweden across clinical subgroups, age, sex, educational level and place of residence and to assess the robustness of register-based case definitions.
IIM was identified from the Swedish National Patient Register and the Swedish Rheumatology Quality Register. The base case definition required ⩾2 visits indicating IIM (first ever with a consecutive visit within 1-12 months for incident cases) and the robustness was tested by applying a more liberal and a stricter definition.
Using the base case definition, 558 incident IIM patients were identified between 2007 and 2011. The incidence was estimated to 11 (13 for women and 9.7 for men) per 1 000 000 person years and was stable across case definitions. Incidence increased with age and peaked at the 50-79 years age groups. No differences were observed between different levels of education and place of residence. We identified 1267 IIM patients on 1 January 2012 corresponding to a prevalence of 14 per 100 000.
We present nationwide register-based incidence and prevalence estimates for IIM, robust across three different case definitions. In contrast to many other reports, we did not find incidence by age to be bimodal and we found no explanation of incidence variation across education and residency. These register-based case definitions can be included in future population-based studies to better understand disease aetiology, risk factors and comorbidities.
评估瑞典特发性炎性肌病(IIM)在不同临床亚组、年龄、性别、教育水平及居住地区的发病率和患病率,并评估基于登记处的病例定义的稳健性。
从瑞典国家患者登记处和瑞典风湿病质量登记处识别IIM。基本病例定义要求有≥2次就诊提示为IIM(对于新发病例,首次就诊后1 - 12个月内有连续就诊),并通过应用更宽松和更严格的定义来测试稳健性。
使用基本病例定义,在2007年至2011年期间识别出558例新发病例IIM患者。发病率估计为每100万人年11例(女性为13例,男性为9.7例),且在不同病例定义中保持稳定。发病率随年龄增加而上升,在50 - 79岁年龄组达到峰值。不同教育水平和居住地区之间未观察到差异。在2012年1月1日,我们识别出1267例IIM患者,患病率为每10万人14例。
我们提供了基于全国登记处的IIM发病率和患病率估计,在三种不同病例定义下均稳健。与许多其他报告不同,我们未发现年龄发病率呈双峰分布,且未发现教育和居住地区发病率差异的解释。这些基于登记处的病例定义可纳入未来基于人群的研究,以更好地了解疾病病因、危险因素和合并症。