瑞典临床诊断银屑病关节炎的发病率。

Incidence of Clinically Diagnosed Psoriatic Arthritis in Sweden.

作者信息

Exarchou Sofia, Di Giuseppe Daniela, Klingberg Eva, Sigurdardottir Valgerdur, Wedrén Sara, Lindström Ulf, Turesson Carl, Jacobsson Lennart T H, Askling Johan, Wallman Johan K

机构信息

S. Exarchou, MD, PhD, Department of Clinical Sciences Malmö, Rheumatology, Lund University, Malmö;

D. Di Giuseppe, PhD, J. Askling, MD, PhD, Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm.

出版信息

J Rheumatol. 2025 Jan 1;52(1):38-46. doi: 10.3899/jrheum.2024-0376.

DOI:10.3899/jrheum.2024-0376

PMID:39278652

Abstract

OBJECTIVE

Prior incidence estimates of psoriatic arthritis (PsA) vary considerably. We aimed to assess the annual incidence of clinically diagnosed PsA among adults in Sweden in 2014-2016, overall and stratified by age/sex/education/geography, and to investigate potential time trends in incidence in 2006-2018. Use of disease-modifying antirheumatic drugs (DMARDs) during the 2 years after diagnosis was also examined.

METHODS

Patients (aged ≥ 18 years) with incident clinically diagnosed PsA in Sweden were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ). Population statistics, stratification variables, and DMARD information were retrieved from other nationwide registers. Incidence was estimated according to a base case (BC) definition (ie, ≥ 1 main International Classification of Diseases, 10th revision, diagnosis of PsA [L40.5/M07.0-M07.3] from rheumatology/internal medicine in NPR, or a PsA diagnosis in SRQ during the relevant year, and no prior such diagnoses) and 4 different sensitivity analysis case definitions.

RESULTS

The mean annual incidence of clinically diagnosed PsA among adults in Sweden in 2014-2016 was estimated at 21.77 per 100,000 person-years (PYs) at risk, according to the BC definition; 17.41 per 100,000 PYs at risk after accounting for diagnostic misclassification; and 15.78 to 28.83 per 100,000 PYs at risk across all sensitivity analyses. Incidence was slightly higher in female individuals, was lower in those with higher education (aged > 12 years), and peaked during the ages of 50 to 59 years. No apparent increasing or decreasing time trend was observed in 2006-2018. Within 2 years of diagnosis, 71.03% of patients had received DMARD therapy (22.37% biologic or targeted synthetic DMARDs).

CONCLUSION

From 2014 to 2016, the annual incidence of clinically diagnosed PsA in the adult Swedish population was approximately 20 per 100,000 PYs at risk. Two years after diagnosis, almost three-quarters of patients had received DMARD therapy.

摘要

目的

既往银屑病关节炎（PsA）的发病率估计差异很大。我们旨在评估2014 - 2016年瑞典成年人中临床诊断的PsA的年发病率，总体情况以及按年龄/性别/教育程度/地理位置分层的情况，并调查2006 - 2018年发病率的潜在时间趋势。还检查了诊断后2年内使用改善病情抗风湿药物（DMARDs）的情况。

方法

从国家患者登记册（NPR）和/或瑞典风湿病质量登记册（SRQ）中识别出瑞典临床诊断为新发PsA的患者（年龄≥18岁）。从其他全国性登记册中获取人口统计学数据、分层变量和DMARD信息。根据基础病例（BC）定义（即，NPR中风湿病/内科的至少1个主要国际疾病分类第10版PsA诊断[L40.5/M07.0 - M07.3]，或相关年份SRQ中的PsA诊断，且之前无此类诊断）和4种不同的敏感性分析病例定义来估计发病率。

结果

根据BC定义，2014 - 2016年瑞典成年人中临床诊断的PsA的年平均发病率估计为每100,000人年（PYs）有21.77例；考虑诊断错误分类后为每100,000 PYs有17.41例；在所有敏感性分析中为每100,000 PYs有15.78至28.83例。女性发病率略高，受教育程度较高（年龄>12岁）者发病率较低，50至59岁年龄段发病率最高。2006 - 2018年未观察到明显的上升或下降时间趋势。诊断后2年内，71.03%的患者接受了DMARD治疗（22.37%使用生物制剂或靶向合成DMARDs）。