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Incidence and prevalence of psoriatic arthritis in Denmark: a nationwide register linkage study
  1. Alexander Egeberg1,
  2. Lars Erik Kristensen2,
  3. Jacob P Thyssen1,
  4. Gunnar Hilmar Gislason3,4,5,
  5. Alice B Gottlieb6,
  6. Laura C Coates7,
  7. Denis Jullien8,
  8. Paolo Gisondi9,
  9. Dafna D Gladman10,
  10. Lone Skov1,
  11. Lotus Mallbris11
  1. 1 Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
  2. 2 Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
  3. 3 Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
  4. 4 The Danish Heart Foundation, Copenhagen, Denmark
  5. 5 The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
  6. 6 Department of Dermatology, New York Medical College, Valhalla, New York, USA
  7. 7 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
  8. 8 Department of Dermatology, Edouard Herriot Hospital, University Claude Bernard Lyon-1, University of Lyon, Lyon, France
  9. 9 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
  10. 10 Division of Rheumatology, Department of Medicine, University of Toronto, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
  11. 11 Eli Lilly and Company, Indianapolis, Indiana, USA
  1. Correspondence to Dr Alexander Egeberg, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark; alexander.egeberg{at}gmail.com

Abstract

Objectives To examine the incidence and temporal trends of psoriatic arthritis (PsA) in the general population in Denmark.

Methods Using nationwide registry data, we estimated the number of patients with incident PsA within each 1-year period between 1997 and 2011 and calculated the rate of PsA cases within gender and age subgroups. Incidence rates were presented per 100 000 person-years.

Results There was a female predominance ranging from 50.3% (1998) to 59.2% (2010), and the mean age at time of diagnosis was 47–50 years. We identified a total of 12 719 patients with PsA (prevalence=0.22%), including 9034 patients where the PsA diagnosis was made by a rheumatologist (prevalence=0.16%). Incidence rates of PsA (per 100 000 person-years) increased from 7.3 in 1997 to a peak incidence of 27.3 in 2010. Incidence rates were highest for women and patients aged 50–59 years, respectively. The use of systemic non-biologic agents, that is, methotrexate, leflunomide, ciclosporin or sulfasalazine increased over the 15-year study course and were used in 66.3% of all patients. Biologic agents (etanercept, infliximab, adalimumab, certolizumab pegol, golimumab or ustekinumab) were used in 17.7% of patients with PsA.

Conclusions We found a clear trend of rising PsA incidence on a national level. While the cause remains unclear, our findings might be explained by increased attention by patients and physicians.

  • Psoriatic arthritis
  • Incidence
  • Prevalence
  • Time trends
  • Epidemiology

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Footnotes

  • Contributors AE and GHG had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AE. Acquisition, analysis and interpretation of data: all authors. Drafting of the manuscript: AE. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: AE and GHG. Obtained funding: AE and LM. Administrative, technical or material support: AE and GHG. Study supervision: AE and GHG.

  • Disclaimer Eli Lilly and Company, the funding source, participated in interpretation of the final analysed study results, but had no access to the raw data and did not participate in data collection, management or analysis.

  • Competing interests AE has received research funding from Pfizer and Eli Lilly and honoraria as consultant and/or speaker from Pfizer, Eli Lilly, Novartis, Galderma and Janssen Pharmaceuticals. LEK has received fees for speaking and consultancy from Pfizer, MSD, AbbVie, UCB, Eli Lilly, Novartis, Celgene, Janssen Pharmaceuticals, Roche, Forward Pharma and BMS. JPT is supported by an unrestricted grant from the Lundbeck Foundation and has received speaker honoraria from Galderma and MEDA. GHG is supported by an unrestricted research scholarship from the Novo Nordisk Foundation. ABG has received honoraria as consultant and/or speaker from Amgen Inc.; Astellas, Akros, Centocor (Janssen), Inc.; Celgene Corp., Bristol Myers Squibb Co., Beiersdorf, Inc., Abbott Labs. (Abbvie), TEVA, Actelion, UCB, Novo Nordisk, Novartis, Dermipsor Ltd, Incyte, Pfizer, Canfite, Lilly, Coronado, Vertex, Karyopharm, CSL Behring Biotherapies for Life, Glaxo Smith Kline, Xenoport, Catabasis, Meiji Seika Pharma Co., Ltd, Takeda, Mitsubishi, Tanabe Pharma Development America, Inc., Genentech, Baxalta, Kineta One, KPI Therapeutics, Crescendo Bioscience, Aclaris, Amicus and Reddy Labs and received research funding (paid to Tuft Medical Center) from Centocor (Janssen), Amgen, Abbott (Abbvie), Novartis, Celgene, Pfizer, Lilly, Levia, Merck, Xenoport, Dermira and Baxalta. LCC has reported no conflicts of interest. DJ has received research funding from Pfizer and honoraria as consultant and/or speaker from Abbvie, Amgen, Celgene, Eli Lilly, Janssen Pharmaceuticals, MSD, Novartis and Pfizer. PG has received honoraria as consultant and/or speaker from AbbVie, Celgene, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, Pfizer and UCB. DDG has received consultancy fees and/or grant support from AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Pfizer, Novartis and UCB. LS has received consultancy and/or speaker honoraria from Abbvie, Pfizer, Janssen-Cilag, Merck Sharp & Dohme and Leo Pharma and is a member of the advisory boards of Abbvie, Pfizer, Leo Pharma, Janssen-Cilag, Merck Sharp & Dohme, Eli Lilly, Celgene and Novartis. LM is currently employed by Eli Lilly and Company.

  • Patient consent Patient consent is not required for register studies per Danish law.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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