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Hossain MM, Wilkerson J, McGrath JA, Farhadi PN, Brokamp C, Khan MTF, Goldberg B, Brunner HI, Macaluso M, Miller FW, Rider LG. The Geospatial Distribution of Myositis and Its Phenotypes in the United States and Associations With Roadways: Findings From a National Myositis Patient Registry. Front Med (Lausanne) 2022; 9:842586. [PMID: 35372396 PMCID: PMC8966380 DOI: 10.3389/fmed.2022.842586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Little is known about the spatial distribution of idiopathic inflammatory myopathies (IIM) in the United States (U.S.), or their geospatial associations. Methods We studied a national myositis patient registry, with cases diagnosed in the contiguous U.S. from 1985–2011 and comprised of dermatomyositis (DM, n = 484), polymyositis (PM, n = 358), and inclusion body myositis (IBM, n = 318) patients. To assess the association of myositis prevalence with distance from roads, we employed log-Gaussian Cox process models, offset with population density. Results The U.S. IIM case distribution demonstrated a higher concentration in the Northest. DM, IBM, and cases with lung disease were more common in the East, whereas PM cases were more common in the Southeast. One area in the West and one area in the South had a significant excess in cases of DM relative to PM and of cases with lung disease relative to those without lung disease, respectively. IIM cases tended to cluster, with between-points interactions more intense in the Northeast and less in the South. There was a trend of a higher prevalence of IIM and its major phenotypes among people living within 50 m of a roadway relative to living beyond 200 m. Demographic characteristics, rural-urban commuting area, and female percentage were significantly associated with the prevalence of IIM and with major phenotypes. Conclusions Using a large U.S. database to evaluate the spatial distribution of IIM and its phenotypes, this study suggests clustering in some regions of the U.S. and a possible association of proximity to roadways.
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Affiliation(s)
- Md M Hossain
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jesse Wilkerson
- Social and Scientific Systems, A DLH Holdings Corp Company, Durham, NC, United States
| | - John A McGrath
- Social and Scientific Systems, A DLH Holdings Corp Company, Durham, NC, United States
| | - Payam N Farhadi
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States.,Kelly Government Solutions, Rockville, MD, United States
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Md T F Khan
- Division of Biostatistics and Bioinformatics, University of Cincinnati, Cincinnati, OH, United States
| | - Bob Goldberg
- The Myositis Association, Alexandria, VA, United States
| | - Hermine I Brunner
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Maurizio Macaluso
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
| | - Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
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Hense S, Luque Ramos A, Callhoff J, Albrecht K, Zink A, Hoffmann F. [Prevalence of rheumatoid arthritis in Germany based on health insurance data : Regional differences and first results of the PROCLAIR study]. Z Rheumatol 2017; 75:819-827. [PMID: 27120440 DOI: 10.1007/s00393-016-0088-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease with a prevalence of up to 1 % in the adult population. OBJECTIVE This study describes the prevalence of RA diagnoses in outpatient health insurance claims data, based on different case definitions and stratified by age, sex and region of residence. METHODS Based on data from a nationwide statutory health insurance fund (BARMER GEK) from the year 2013, a cross-sectional study of insurants aged 18 years or older was conducted. The following case definitions were applied: A) a diagnosis of seropositive rheumatoid arthritis (M05) or other rheumatoid arthritis (M06) according to the international classification of diseases 10 German modification (ICD-10-GM) in at least two quarterly periods of the year 2013, B) case definition A plus determination of C‑reactive protein (CRP) or erythrocyte sedimentation rate (ESR) at least once, C) case definition B plus specific drug therapy and D) case definition A plus treatment by a rheumatologist. Raw as well as age and sex-standardized prevalences were calculated and stratified according to the federal state. RESULTS The study population consisted of 7,155,315 insurants of whom 60.2 % were female. Overall, RA prevalences for the respective case definitions were 1.62 % (A), 1.11 % (B), 0.94 % (C) and 0.64 % (D). When standardized to the German population the prevalences were 1.38 % (A), 0.95 % (B), 0.81 % (C) and 0.55 % (D). The proportion of women was approximately 80 % for all case definitions. Prevalences increased with age, peaking in the age group 70-79 years old and showing the highest values in eastern and the lowest in southern Germany for raw as well as standardized measures. CONCLUSION Regional differences in the prevalence of RA diagnoses in health insurance claims data were observed independent of age, sex and case definition. The expected prevalence according to the results of international studies was best achieved when case definitions with CRP or ESR were considered.
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Affiliation(s)
- S Hense
- Department für Versorgungsforschung, Fakultät für Medizin und Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstr. 140, 26111, Oldenburg, Deutschland.,Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - A Luque Ramos
- Department für Versorgungsforschung, Fakultät für Medizin und Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstr. 140, 26111, Oldenburg, Deutschland
| | - J Callhoff
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - K Albrecht
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - A Zink
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland.,Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - F Hoffmann
- Department für Versorgungsforschung, Fakultät für Medizin und Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstr. 140, 26111, Oldenburg, Deutschland.
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Walldius G, Malmström H, Jungner I, de Faire U, Lambe M, Van Hemelrijck M, Hammar N. Cohort Profile: The AMORIS cohort. Int J Epidemiol 2017; 46:1103-1103i. [DOI: 10.1093/ije/dyw333] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 01/22/2023] Open
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Eriksson K, Nise L, Kats A, Luttropp E, Catrina AI, Askling J, Jansson L, Alfredsson L, Klareskog L, Lundberg K, Yucel-Lindberg T. Prevalence of Periodontitis in Patients with Established Rheumatoid Arthritis: A Swedish Population Based Case-Control Study. PLoS One 2016; 11:e0155956. [PMID: 27203435 PMCID: PMC4874595 DOI: 10.1371/journal.pone.0155956] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/06/2016] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The possible hypothesis of a link between periodontitis and rheumatoid arthritis (RA), specifically anti-citrullinated protein antibody (ACPA) positive RA, prompted us to investigate the prevalence of periodontitis in the Swedish Epidemiological Investigation of RA (EIRA), a well-characterised population-based RA case-control cohort. METHODS Periodontal status of 2,740 RA cases and 3,942 matched controls was retrieved through linking EIRA with the National Dental Health Registry (DHR), where dental diagnostic- and treatment codes on the adult Swedish population have been registered. Dental records from 100 cases and controls were reviewed to validate the periodontal diagnostic codes in DHR. RESULTS The reviewed dental records confirmed 90% of the periodontitis diagnoses in DHR among RA cases, and 88% among controls. We found the positive predictive value of periodontitis diagnoses in the DHR to be 89% (95% CI 78 to 95%) with a sensitivity of 77% (95% CI: 65 to 86%). In total, 86% of EIRA participants were identified in DHR. The risk for periodontitis increased by age and current smoking status in both cases as well as controls. No significant differences in prevalence of periodontal disease in terms of gingivitis, periodontitis, peri-implantitis or increased risk for periodontitis or peri-implantitis were observed between RA cases and controls. In addition, there was no difference on the basis of seropositivity, ACPA or rheumatoid factor (RF), among patients with RA. CONCLUSIONS Our data verify that smoking and ageing are risk factors for periodontitis, both in RA and controls. We found no evidence of an increased prevalence of periodontitis in patients with established RA compared to healthy controls, and no differences based on ACPA or RF status among RA subjects.
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Affiliation(s)
- Kaja Eriksson
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Lena Nise
- Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Anna Kats
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Elin Luttropp
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Anca Irinel Catrina
- Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Johan Askling
- Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Leif Jansson
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
- Department of Periodontology at Eastmaninstitutet, Stockholm County Council, Stockholm, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
- Centre of Environmental and Occupational Medicine, Stockholm County Council, Stockholm, Sweden
| | - Lars Klareskog
- Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Karin Lundberg
- Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Tülay Yucel-Lindberg
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
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Turk SA, van Beers-Tas MH, van Schaardenburg D. Prediction of future rheumatoid arthritis. Rheum Dis Clin North Am 2014; 40:753-70. [PMID: 25437290 DOI: 10.1016/j.rdc.2014.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Rheumatoid arthritis (RA) results from an interaction between genetic susceptibility and environmental factors. Several of these factors are known, such as family history of RA, high birth weight, smoking, silica exposure, alcohol nonuse, obesity, diabetes mellitus, rheumatoid factor, anti-citrullinated protein antibody, and genetic variants such as the shared epitope and protein tyrosine phosphatase nonreceptor type 22. The impact of these factors can be modeled in the 2 main groups at risk of RA: family members of patients with RA and seropositive persons with or without arthralgia. Current models have the potential to select individuals for preventive strategies.
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Affiliation(s)
- Samina A Turk
- Department of Rheumatology, Jan van Breemen Research Institute/Reade, Doctor Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands.
| | - Marian H van Beers-Tas
- Department of Rheumatology, Jan van Breemen Research Institute/Reade, Doctor Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands
| | - Dirkjan van Schaardenburg
- Department of Rheumatology, Jan van Breemen Research Institute/Reade, Doctor Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands
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