Background With the growing knowledge, the diagnostic and therapeutic opportunities of most inflammatory rheumatic diseases have intensified during the recent decades. This has led to improved functional outcomes in the vast majority of patients, but also to a certain dependency of specialist care in these patients, which, in the face of the current decreasing numbers of practicing rheumatologists raises concerns about the abundance of the health care resources. Some earlier reports have shown a decreasing incidence of rheumatoid arthritis (RA) in Eastern Finland; however there is no data on other diagnoses, and the experience from clinical practice contradicts these findings. Thus, to be able to optimally meet the future needs of rheumatological therapy, the total burden of new inflammatory rheumatic diseases needs to be assessed.
Methods From the Finnish nationwide register maintained by the Social Institute of Insurance (SII) we collected data on all patients granted a new special reimbursement on medications for various inflammatory rheumatic diseases from January 1st 2000 to December 31st 2014. The diagnoses were: juvenile arthritis (all patients aged 0–16 years with ICD-10 diagnosis M02-M46), and for patients >16 years, seropositive rheumatoid arthritis (RA) (M05), seronegative RA (M06), spondylarthritis (M45-M46), unspecified arthritis (M13) and psoriatic arthritis (L40.5). The total number of new patients and the incidences for each diagnosis /100 000 patient years in these age groups were counted in 3-year cohorts.
Results During the observation time altogether 54 658 patients (61.7% female) with a new diagnosis of a rheumatic disease and an initiated treatment were identified. The total incidence of inflammatory rheumatic diseases increased linearly from the first cohort's 63/100 000/patient years to the last cohort's (2012–14) 76/100 000/patient years, and the absolute yearly number of newly diagnosed patients increased 1.39-fold during the follow-up. The characteristics of each diagnosis group are presented in the Table.
Conclusions The total burden new of rheumatic diseases has increased during this millennium. The incidence of seropositive RA has remained stable and only that of seronegative RA has decreased slightly. However, the incidence unspecified and psoriatic arthritis, as well as spondylarthritis has increased clearly. Thus, with increasing numbers of new patients the recourses for rheumatological treatment should increase accordingly to face their needs.
Disclosure of Interest None declared