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英国索尔福德市成人特发性炎性肌病发病率上升:一项为期10年的流行病学研究。

Increasing incidence of adult idiopathic inflammatory myopathies in the City of Salford, UK: a 10-year epidemiological study.

作者信息

Parker Matthew J S, Oldroyd Alexander, Roberts Mark E, Ollier William E, New Robert P, Cooper Robert G, Chinoy Hector

机构信息

Rheumatology Department, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Salford.

NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester.

出版信息

Rheumatol Adv Pract. 2018 Sep 17;2(2):rky035. doi: 10.1093/rap/rky035. eCollection 2018.

Abstract

OBJECTIVES

The aim was to identify and characterize all incident adult cases of idiopathic inflammatory myopathies (IIM) between 1 January 2007 and 31 December 2016 in the City of Salford, UK.

METHODS

Adults first diagnosed with IIM within the study period were identified by: a Salford Royal NHS Foundation Trust (SRFT) inpatient episode IIM-specific ICD-10 coding search; all new patient appointments to SRFT neuromuscular outpatient clinics; and all Salford residents enrolled within the UKMYONET study. All patients with definite IIM by the 2017 EULAR/ACR classification criteria were included, as were probable cases if consensus expert opinion agreed. Cases were excluded if <18 years of age at disease onset, if they did not meet probable criteria or when probable but expert opinion concluded a non-IIM diagnosis.

RESULTS

The multimodal case ascertainment identified 1156 cases which, after review and application of exclusion criteria, resulted in 32 incident cases during the study period. Twenty-three of 32 were female, with a mean age of 58.1 years. The mean incidence of adult IIM was 17.6/1 000 000 person years, and higher for females than for males (25.2 10.0/1 000 000 person years, respectively). A significant incidence increase over time was apparent (13.6 21.4/1 000 000 person years;  = 0.032). Using EULAR/ACR classification criteria, the largest IIM subtype (21/32) was PM, followed by DM (8/32), IBM (2/32) and amyopathic DM (1/32). Expert opinion subtype differed from EULAR/ACR classification criteria in 19/32 cases.

CONCLUSION

The incidence of adult IIM in Salford is 17.6/1 000 000 person years, higher in females, and is increasing over time. Disagreement exists between EULAR/ACR-derived and expert opinion-derived IIM subtype assignments.

摘要

目的

旨在识别并描述2007年1月1日至2016年12月31日期间英国索尔福德市所有特发性炎性肌病(IIM)的成年发病病例。

方法

通过以下方式识别在研究期间首次被诊断为IIM的成年人:索尔福德皇家国民保健服务基金会信托基金(SRFT)住院病历中特定IIM的ICD - 10编码搜索;SRFT神经肌肉门诊诊所的所有新患者预约;以及UKMYONET研究中登记的所有索尔福德居民。纳入所有符合2017年欧洲抗风湿病联盟(EULAR)/美国风湿病学会(ACR)分类标准的确诊IIM患者,若专家共识意见一致,可能病例也纳入。若发病年龄<18岁、不符合可能标准或虽为可能病例但专家意见判定为非IIM诊断,则排除该病例。

结果

多模式病例确定法识别出1156例病例,经审查并应用排除标准后,研究期间有32例发病病例。32例中有23例为女性,平均年龄58.1岁。成年IIM的平均发病率为17.6/1000000人年,女性高于男性(分别为25.2和10.0/1000000人年)。发病率随时间有显著上升(13.6至21.4/1000000人年;P = 0.032)。根据EULAR/ACR分类标准,最大的IIM亚型为多发性肌炎(PM,21/32),其次是皮肌炎(DM,8/32)、包涵体肌炎(IBM,2/32)和无肌病性皮肌炎(1/32)。在32例病例中,19例专家意见亚型与EULAR/ACR分类标准不同。

结论

索尔福德成年IIM的发病率为17.6/1000000人年,女性发病率更高,且随时间上升。EULAR/ACR衍生亚型与专家意见衍生亚型在IIM亚型分类上存在分歧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/520f/6649983/09cc50849681/rky035f1.jpg

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