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Clinical Rheumatology

, Volume 38, Issue 2, pp 555–562 | Cite as

Increasing incidence and shifting profile of idiopathic inflammatory rheumatic diseases in adults during this millennium

  • Paula MuiluEmail author
  • Vappu Rantalaiho
  • Hannu Kautiainen
  • Lauri Juhani Virta
  • Johan Gunnar Eriksson
  • Kari Puolakka
Original Article

Abstract

To explore the trends in the incidence of idiopathic inflammatory rheumatic diseases (IIRDs) after the turn of the millennium. From a nationwide register maintained by the Social Insurance Institution of Finland, we collected all adult patients with IIRDs granted a new special reimbursement for anti-rheumatic drugs between 2000 and 2014. Temporal trends in the incidences of various IIRDs were estimated in three 5-year intervals. A total of 58,405 adult patients were identified. Between 2000–2004 and 2010–2014, the age-adjusted incidence rate of IIRDs increased from 114 to 116/100000 [incidence rate ratio (IRR) 1.03 (95% CI 1.01 to 1.06)] in women and from 67 to 69/100,000 [IRR 1.10 (95% CI 1.06–1.14)] in men. The incidence of seropositive rheumatoid arthritis (RA) remained stable while that of seronegative RA decreased. For other diagnoses, the incidences either increased (unspecified arthritis, psoriatic arthritis, spondyloarthritis), remained stable (reactive arthritis), or decreased (SLE and the group of diseases with the ICD-10 code M35). The gender difference in spondyloarthritis leveled as the incidence in women increased at a higher rate than in men. Mean age at IIRD diagnosis decreased among women. The total age-adjusted incidence of IIRDs has gradually increased, due to the increase in unspecified arthritis, psoriatic arthritis, and spondyloarthritis. This, in addition to the ascending number of individuals at risk in the population, translates into a growing burden to the health care system.

Keywords

Ankylosing spondylitis Epidemiology Psoriatic arthritis Rheumatoid arthritis Spondyloarthritis Unspecified arthritis 

Notes

Funding information

This study was funded by Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital, the Finnish Rheumatology Research Foundation, Tampereen Reumayhdistys, and by the Finnish Cultural Foundation.

Compliance with ethical standards

Disclosure statement

Dr. Puolakka, Dr. Virta, Dr. Eriksson, and Mr. Kautiainen have nothing to disclose. Dr. Rantalaiho reports a speaker’s honorarium and a congress trip from Pfizer and a congress trip from Celegen outside the submitted work. Dr. Muilu reports a Congress trip from UCB Pharma and a Congress trip from MSD Finland outside the submitted work.

References

  1. 1.
    Widdifield J, Paterson JM, Bernatsky S, Tu K, Tomlinson G, Kuriya B, Thorne JC, Bombardier C (2014) The epidemiology of rheumatoid arthritis in Ontario, Canada. Arthritis Rheum 66:786–793CrossRefGoogle Scholar
  2. 2.
    Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE (2010) Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955–2007. Arthritis Rheum 62:1576–1582CrossRefGoogle Scholar
  3. 3.
    Eriksson JK, Neovius M, Ernestam S, Lindblad S, Simard JF, Askling J (2013) Incidence of rheumatoid arthritis in Sweden: a nationwide population-based assessment of incidence, its determinants, and treatment penetration. Arthritis Care Res 65:870–878CrossRefGoogle Scholar
  4. 4.
    Di WT, Vergara F, Bertiller E, Gallardo Mde L, Gandino I, Scolnik M et al (2016) Incidence and prevalence of rheumatoid arthritis in a health management organization in Argentina: a 15-year study. J Rheumatol 43:1306–1311CrossRefGoogle Scholar
  5. 5.
    Fina-Aviles F, Medina-Peralta M, Mendez-Boo L, Hermosilla E, Elorza JM, Garcia-Gil M, Ramos R, Bolibar B, Javaid MK, Edwards CJ, Cooper C, Arden NK, Prieto-Alhambra D (2016) The descriptive epidemiology of rheumatoid arthritis in Catalonia: a retrospective study using routinely collected data. Clin Rheumatol 35:751–757CrossRefGoogle Scholar
  6. 6.
    Kaipiainen-Seppanen O, Kautiainen H (2006) Declining trend in the incidence of rheumatoid factor-positive rheumatoid arthritis in Finland 1980–2000. J Rheumatol 33:2132–2138Google Scholar
  7. 7.
    Puolakka K, Kautiainen H, Pohjolainen T, Virta L (2010) Rheumatoid arthritis (RA) remains a threat to work productivity: a nationwide register-based incidence study from Finland. Scand J Rheumatol 39:436–438CrossRefGoogle Scholar
  8. 8.
    Savolainen E, Kaipiainen-Seppanen O, Kroger L, Luosujarvi R (2003) Total incidence and distribution of inflammatory joint diseases in a defined population: results from the Kuopio 2000 arthritis survey. J Rheumatol 30:2460–2468Google Scholar
  9. 9.
    Kononoff A, Arstila L, Pussinen P, Kautiainen H, Elfving P, Savolainen E, Niinisalo H, Rutanen J, Marjoniemi O, Kaipiainen-Seppänen O (2017) Incidence of inflammatory joint diseases in Finland: results from a population-based epidemiological study. Rheumatol Int 37:1693–1700CrossRefGoogle Scholar
  10. 10.
    Kaipiainen-Seppanen O, Aho K, Heliovaara M (1997) Incidence and prevalence of ankylosing spondylitis in Finland. J Rheumatol 24:496–499Google Scholar
  11. 11.
    Hukuda S, Minami M, Saito T, Mitsui H, Matsui N, Komatsubara Y, Makino H, Shibata T, Shingu M, Sakou T, Shichikawa K (2001) Spondyloarthropathies in Japan: nationwide questionnaire survey performed by the Japan ankylosing spondylitis society. J Rheumatol 28:554–559Google Scholar
  12. 12.
    Bakland G, Nossent HC, Gran JT (2005) Incidence and prevalence of ankylosing spondylitis in Northern Norway. Arthritis Rheum 53:850–855CrossRefGoogle Scholar
  13. 13.
    Haroon NN, Paterson JM, Li P, Haroon N (2014) Increasing proportion of female patients with ankylosing spondylitis: a population-based study of trends in the incidence and prevalence of AS. BMJ Open.  https://doi.org/10.1136/bmjopen-2014-006634
  14. 14.
    Hoff M, Gulati AM, Romundstad PR, Kavanaugh A, Haugeberg G (2015) Prevalence and incidence rates of psoriatic arthritis in Central Norway: data from the Nord-Trondelag health study (HUNT). Ann Rheum Dis 74:60–64CrossRefGoogle Scholar
  15. 15.
    Soriano ER, Rosa J, Velozo E, Schpilberg M, Imamura PM, Diaz J, Catoggio LJ (2011) Incidence and prevalence of psoriatic arthritis in Buenos Aires, Argentina: a 6-year health management organization-based study. Rheumatology (Oxford) 50:729–734CrossRefGoogle Scholar
  16. 16.
    Soderlin MK, Borjesson O, Kautiainen H, Skogh T, Leirisalo-Repo M (2002) Annual incidence of inflammatory joint diseases in a population based study in Southern Sweden. Ann Rheum Dis 61:911–915CrossRefGoogle Scholar
  17. 17.
    Kaipiainen-Seppanen O (1996) Incidence of psoriatic arthritis in Finland. Br J Rheumatol 35:1289–1291CrossRefGoogle Scholar
  18. 18.
    Hanova P, Pavelka K, Holcatova I, Pikhart H (2010) Incidence and prevalence of psoriatic arthritis, ankylosing spondylitis, and reactive arthritis in the first descriptive population-based study in the Czech Republic. Scand J Rheumatol 39:310–317CrossRefGoogle Scholar
  19. 19.
    Townes JM, Deodhar AA, Laine ES, Smith K, Krug HE, Barkhuizen A, Thompson ME, Cieslak PR, Sobel J (2008) Reactive arthritis following culture-confirmed infections with bacterial enteric pathogens in Minnesota and Oregon: a population-based study. Ann Rheum Dis 67:1689–1696CrossRefGoogle Scholar
  20. 20.
    Elfving P, Puolakka K, Kautiainen H, Virta LJ, Pohjolainen T, Kaipiainen-Seppanen O (2014) Incidence of systemic lupus erythematosus in Finland, 2000–2007, a nationwide study. Clin Exp Rheumatol 32:953–955Google Scholar
  21. 21.
    Somers EC, Marder W, Cagnoli P, Lewis EE, DeGuire P, Gordon C, Helmick CG, Wang L, Wing JJ, Dhar JP, Leisen J, Shaltis D, McCune WJ (2014) Population-based incidence and prevalence of systemic lupus erythematosus: the Michigan lupus epidemiology and surveillance program. Arthritis Rheum 66:369–378CrossRefGoogle Scholar
  22. 22.
    See LC, Kuo CF, Chou IJ, Chiou MJ, Yu KH (2013) Sex- and age-specific incidence of autoimmune rheumatic diseases in the Chinese population: a Taiwan population-based study. Semin Arthritis Rheum 43:381–386CrossRefGoogle Scholar
  23. 23.
    Maciel G, Crowson CS, Matteson EL, Cornec D (2017) Incidence and mortality of physician-diagnosed primary Sjogren syndrome: time trends over a 40-year period in a population-based US cohort. Mayo Clin Proc 92:734–743CrossRefGoogle Scholar
  24. 24.
    Raheel S, Shbeeb I, Crowson CS, Matteson EL (2017) Epidemiology of polymyalgia rheumatica 2000–2014 and examination of incidence and survival trends over 45 years: a population based study. Arthritis Care Res 69:1282–1285CrossRefGoogle Scholar
  25. 25.
    Furu K, Wettermark B, Andersen M, Martikainen JE, Almarsdottir AB, Sorensen HAT (2010) The Nordic countries as a cohort for pharmacoepidemiological research. Basic Clin Pharmacol Toxicol 106:86–94CrossRefGoogle Scholar
  26. 26.
    Han GM, Michaud K, Yu F, Watanabe-Galloway S, Mikuls TR (2016) Increasing public health burden of arthritis and other rheumatic conditions and comorbidity: results from a statewide health surveillance system, 2007–2012. Arthritis Care Res 68:1417–1427CrossRefGoogle Scholar
  27. 27.
    Yu KH, See LC, Kuo CF, Chou IJ, Chou MJ (2013) Prevalence and incidence in patients with autoimmune rheumatic diseases: a nationwide population-based study in Taiwan. Arthritis Care Res 65:244–250CrossRefGoogle Scholar
  28. 28.
    Isomaki H, Raunio J, von Essen R, Hameenkorpi R (1978) Incidence of inflammatory rheumatic diseases in Finland. Scand J Rheumatol 7:188–192CrossRefGoogle Scholar
  29. 29.
    Shichikawa K, Inoue K, Hirota S, Maeda A, Ota H, Kimura M, Ushiyama T, Tsujimoto M (1999) Changes in the incidence and prevalence of rheumatoid arthritis in Kamitonda, Wakayama, Japan, 1965–1996. Ann Rheum Dis 58:751–756CrossRefGoogle Scholar
  30. 30.
    Doran MF, Pond GR, Crowson CS, O'Fallon WM, Gabriel SE (2002) Trends in incidence and mortality in rheumatoid arthritis in Rochester, Minnesota, over a forty-year period. Arthritis Rheum 46:625–631CrossRefGoogle Scholar
  31. 31.
    Abhishek A, Doherty M, Kuo CF, Mallen CD, Zhang W, Grainge MJ (2017) Rheumatoid arthritis is getting less frequent-results of a nationwide population-based cohort study. Rheumatology (Oxford) 56:736–744Google Scholar
  32. 32.
    Pedersen JK, Svendsen AJ, Horslev-Petersen K (2007) Incidence of rheumatoid arthritis in the southern part of Denmark from 1995 to 2001. Open Rheumatol J 1:18–23CrossRefGoogle Scholar
  33. 33.
    Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581CrossRefGoogle Scholar
  34. 34.
    Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM (2009) Time trends in epidemiology and characteristics of psoriatic arthritis over 3 decades: a population-based study. J Rheumatol 36:361–367CrossRefGoogle Scholar
  35. 35.
    van der Linden S, Khan MA (2016) Can we currently and confidently assess the true burden of illness due to non-radiographic axial spondyloarthritis? Clin Exp Rheumatol 34:963–965Google Scholar
  36. 36.
    Sieper J, Poddubnyy D (2017) Axial spondyloarthritis. Lancet 390:73–84CrossRefGoogle Scholar
  37. 37.
    Uramoto KM, Michet CJ Jr, Thumboo J, Sunku J, O’Fallon WM, Gabriel SE (1999) Trends in the incidence and mortality of systemic lupus erythematosus, 1950–1992. Arthritis Rheum 42:46–50CrossRefGoogle Scholar
  38. 38.
    Hermansen ML, Lindhardsen J, Torp-Pedersen C, Faurschou M, Jacobsen S (2016) Incidence of systemic lupus erythematosus and lupus nephritis in Denmark: a nationwide cohort study. J Rheumatol 43:1335–1339CrossRefGoogle Scholar
  39. 39.
    Kaipiainen-Seppanen O, Aho K, Isomaki H, Laakso M (1996) Shift in the incidence of rheumatoid arthritis toward elderly patients in Finland during 1975–1990. Clin Exp Rheumatol 14:537–542Google Scholar
  40. 40.
    Sugiyama D, Nishimura K, Tamaki K, Tsuji G, Nakazawa T, Morinobu A, Kumagai S (2010) Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis 69:70–81CrossRefGoogle Scholar
  41. 41.
    Lahiri M, Morgan C, Symmons DP, Bruce IN (2012) Modifiable risk factors for RA: prevention, better than cure? Rheumatology (Oxford) 51:499–512CrossRefGoogle Scholar
  42. 42.
    Heloma A, Puska P (2016) Tobacco control: From north karelia to the national level. Glob Heart 11:185–189CrossRefGoogle Scholar
  43. 43.
    Wibetoe G, Ikdahl E, Rollefstad S, Olsen IC, Bergsmark K, Kvien TK, Salberg A, Soldal DM, Bakland G, Lexberg Å, Fevang BT, Gulseth HC, Haugeberg G, Semb AG (2017) Cardiovascular disease risk profiles in inflammatory joint disease entities. Arthritis Res Ther 19:153CrossRefGoogle Scholar
  44. 44.
    Maas F, Arends S, van der Veer E, Wink F, Efde M, Bootsma H, Brouwer E, Spoorenberg A (2016) Obesity is common in axial spondyloarthritis and is associated with poor clinical outcome. J Rheumatol 43:383–387CrossRefGoogle Scholar
  45. 45.
    Mannisto S, Laatikainen T, Harald K et al (2015) The trend towards increasing obesity seems to have slowed down in the working aged Finnish population - results from the national FINRISK studies. Suomen laakarilehti 70:969–675Google Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Department of MedicineTampere University HospitalTampereFinland
  2. 2.Centre for Rheumatic DiseasesTampere University HospitalTampereFinland
  3. 3.Faculty of Medicine and Life SciencesUniversity of TampereTampereFinland
  4. 4.Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland
  5. 5.Unit of Primary Health CareTurku University HospitalTurkuFinland
  6. 6.Research DepartmentSocial Insurance Institution of FinlandTurkuFinland
  7. 7.Folkhälsan Research CenterHelsinkiFinland
  8. 8.Department of MedicineSouth Karelia Central HospitalLappeenrantaFinland

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