Rheumatoid arthritis is getting less frequent-results of a nationwide population-based cohort study
Rheumatoid arthritis is getting less frequent-results of a nationwide population-based cohort study
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DOI：
10.1093/rheumatology/kew468
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发表时间：
2017-05-01
期刊：
影响因子：
5.5
通讯作者：
Grainge, Matthew J.
中科院分区：
文献类型：
--
作者：
Abhishek, Abhishek;Doherty, Michael;Grainge, Matthew J.
目标.本研究的目的是检查1990年至2014年期间RA发病率和患病率的变化，并探讨英国RA发病率和患病率是否存在任何地理差异。这是一项基于初级保健的前瞻性队列研究。纳入了1990年1月1日至2014年12月31日期间向临床实践研究数据链提供可接受数据的人员。读取代码用于识别≥ 18岁的RA病例。将各年的患病率和发病率标准化为2014年人口，并将2014年RA的区域发病率和患病率标准化为总人口。2014年RA的发病率和患病率分别为3.81/10 000人年和0.67%。1990年至2014年间，RA的年发病率下降了1.6%（95% CI 0.8，2.5），1994年和2002年的联合点具有显著性。RA的患病率从1990年至2005年每年增加3.7%（95% CI 3.2，4.1），2005年至2014年每年下降1.1%（95% CI 2.0，0.2）。英国不同地区RA的发病率存在显著差异，东米德兰兹、约克郡和亨伯的发病率最高，东北、约克郡和亨伯的患病率最高。RA的发病率正在下降，近年来患病率有所下降。在英国，RA的发生率存在显著的地理差异。需要进一步的研究来确定这种现象背后的原因，以便可以设计公共卫生干预措施来进一步降低RA的发病率。
Objectives. The objectives of this study were to examine changes in the incidence and prevalence of RA between 1990 and 2014 and to explore if there is any geographic variation in the incidence and prevalence of RA in the UK.Methods. This was a primary care-based prospective cohort study. People contributing acceptable data to Clinical Practice Research Datalink between 1 January 1990 and 31 December 2014 were included. Read codes were used to identify RA cases >= 18 years of age. The prevalence and incidence rates for each year were standardized to the 2014 population and the regional incidence and prevalence of RA for the year 2014 were standardized to the overall population.Results. The incidence and prevalence of RA was 3.81/10 000 person-years and 0.67%, respectively, in 2014. The annual incidence of RA decreased by 1.6% (95% CI 0.8, 2.5) between 1990 and 2014, with significant joinpoints at 1994 and 2002. The prevalence of RA increased by 3.7%/year (95% CI 3.2, 4.1) from 1990 to 2005 and decreased by 1.1%/year (95% CI 2.0, 0.2) between 2005 and 2014. There were significant differences in the occurrence of RA throughout different regions of the UK, with the highest incidence in East Midlands, Yorkshire and Humber and the highest prevalence in North East, Yorkshire and Humber.Conclusion. The incidence of RA is decreasing, with a reduction in prevalence in recent years. There is significant geographic variation in the occurrence of RA in the UK. Further research is required to identify the reasons underlying this phenomenon so that public health interventions can be designed to further reduce the incidence of RA.