Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990 to 2001

Liam Smeeth ^1*, Claire Cook ¹ and Andrew J Hall ¹

¹ London School of Hygiene and Tropical Medicine, United Kingdom

^* To whom correspondence should be addressed. E-mail: liam.smeeth{at}lshtm.ac.uk.

Accepted 9 January 2006

Abstract

Objective: to investigate time trends, geographic variation and seasonality in the incidence of diagnosis of polymyalgia rheumatica and temporal arteritis in the United Kingdom.

Methods: analysis of computerized medical records from United Kingdom general practices. Participants were people registered with a practice contributing to the General Practice Research Database during the period 1990 to 2001. The main outcome measures were rates of diagnosis by year, age, gender, geographic region and calendar month.

Results: 15,013 people had a first diagnosis of polymyalgia rheumatica and 3928 a first diagnosis of temporal arteritis during 17,830,028 million person- years of observation. The age adjusted incidence rate of PMR was 8.4/10,000 person years (95% CI 8.3 to 8.6), rising from 6.9/10,000 person years in 1990 to 9.3/10,000 in 2001. The age adjusted incidence rate of TA was 2.2/10,000 person years (95% CI 2.1 to 2.3) with no increase observed. Both PMR and TA were more common in the south compared with the north of the United Kingdom, and both were more commonly diagnosed in the summer months.

Conclusions: The explanation for the findings is unclear. Variations in diagnostic practice and accuracy are likely to have contributed in part to the patterns observed. However, the findings are also likely to reflect, at least in part, variations in the incidence of disease. The striking geographical pattern may be partly attributable to a risk factor which is more prevalent in the south and east of the United Kingdom.

Keywords: United Kingdom, diagnosis, incidence, polymyalgia rheumatica, temporal arteritis

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