Epidemiological aspects of ankylosing spondylitis in Sweden. Characterization, prevalence and prognosis
Author
Summary, in English
Ankylosing Spondylitis (AS) is a chronic, potentially disabling, inflammatory disease that poses a longstanding burden on the patient and the society. The epidemiology of AS in Sweden has not been extensively studied previously.
Radiographic and self-perceived health information from 1,005 men aged 69-81 years, showed a prevalence of moderate to severe radiographic sacroiliitis of 1.4% (95% Confidence Interval (CI): 0.7-2.4), with modest impact on health. Medical records of a representative sample of 500 patients with a registered visit to a physician with a diagnosis of AS or undifferentiated spondyloarthritis (uSpA) in the National Patient Register (NPR) (2007-2009) were reviewed. These diagnoses had high validity, as 70% of patients with an AS diagnosis fulfilled the modified New York (mNY) criteria for AS and 79% of patients with a diagnosis of uSpA fulfilled any set of the SpA criteria. Based on clinically diagnosed patients with AS in the NPR, identification of referents from the general population and linkage of these two groups to other national registers, the prevalence and mortality of AS were studied. The prevalence of clinically diagnosed AS was 0.18% in 2009, with higher estimates in men, in northern Sweden, and in those with lower level of education. Men more often had anterior uveitis and treatment with TNF-inhibitors compared to women, and women had more often peripheral arthritis, psoriasis and treatment with oral glucocorticosteroids. The all-cause mortality was increased in patients with AS compared to the general population, overall (age- and sex-adjusted hazard ratio (HR) 1.60 (95% CI: 1.44-1.77)) and separately for males and females. Predictors of death within the AS cohort included a lower level of formal education, general co-morbidities and joint surgery.
Radiographic and self-perceived health information from 1,005 men aged 69-81 years, showed a prevalence of moderate to severe radiographic sacroiliitis of 1.4% (95% Confidence Interval (CI): 0.7-2.4), with modest impact on health. Medical records of a representative sample of 500 patients with a registered visit to a physician with a diagnosis of AS or undifferentiated spondyloarthritis (uSpA) in the National Patient Register (NPR) (2007-2009) were reviewed. These diagnoses had high validity, as 70% of patients with an AS diagnosis fulfilled the modified New York (mNY) criteria for AS and 79% of patients with a diagnosis of uSpA fulfilled any set of the SpA criteria. Based on clinically diagnosed patients with AS in the NPR, identification of referents from the general population and linkage of these two groups to other national registers, the prevalence and mortality of AS were studied. The prevalence of clinically diagnosed AS was 0.18% in 2009, with higher estimates in men, in northern Sweden, and in those with lower level of education. Men more often had anterior uveitis and treatment with TNF-inhibitors compared to women, and women had more often peripheral arthritis, psoriasis and treatment with oral glucocorticosteroids. The all-cause mortality was increased in patients with AS compared to the general population, overall (age- and sex-adjusted hazard ratio (HR) 1.60 (95% CI: 1.44-1.77)) and separately for males and females. Predictors of death within the AS cohort included a lower level of formal education, general co-morbidities and joint surgery.
Department/s
Publishing year
2015
Language
English
Publication/Series
Lund University Faculty of Medicine Doctoral Dissertation Series
Volume
2015:62
Document type
Dissertation
Publisher
Department of Clinical Sciences, Lund University
Topic
- Clinical Medicine
Status
Published
Research group
- Internal Medicine - Epidemiology
Supervisor
- Lennart Jacobsson
- Lars Erik Kristensen
- Carl Turesson
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-7619-141-5
Defence date
28 May 2015
Defence time
09:00
Defence place
Aula, Clinical Research Center, Jan Waldenströms gata 35, Skånes universitetssjukhus, Malmö
Opponent
- Glenn Haugeberg (Professor)