TY - JOUR
T1 - Epidemiology of scleritis in the United Kingdom from 1997 to 2018
T2 - population-based analysis of 11 million patients and association between scleritis and infectious and immune-mediated inflammatory disease
AU - Braithwaite, Tasanee
AU - Adderley, Nicola
AU - Subramanian, Anuradhaa
AU - Galloway, James
AU - Kempen, John H.
AU - Gokhale, Krishna
AU - Cope, Andrew P
AU - Dick, Andrew D.
AU - Nirantharakumar, Krishnarajah
AU - Denniston, Alastair
PY - 2021/3/16
Y1 - 2021/3/16
N2 - Objective
To estimate 22‐year trends in scleritis prevalence and
incidence and associations with infectious/immune‐mediated inflammatory
diseases (I‐IMIDs) in the United Kingdom (UK).
Methods
Retrospective cross‐sectional and population cohort study
(1997‐2018) included 10,939,823 patients (n=2946 incident scleritis cases) in
The Health Improvement Network (THIN), a nationally‐representative primary care
records database. Case‐control and cohort study (1995‐2019) included 3005
incident scleritis cases and 12,020 control patients matched by age, sex,
region and Townsend Deprivation Index (TDI). We adjusted Poisson, Logistic and
Cox proportional hazard multivariable models by age, sex, TDI, race/ethnicity,
smoking, nation and body mass index category. Estimates include 95% confidence
intervals.
Results
Scleritis incidence rates declined from 4·23(2·16‐6·31) to
2·79(2·19‐3·39) per 100,000 person‐years between 1997 and 2018. Prevalence was
93·62(90·17‐97·07)/100,000 people in 2018 (61,650 UK patients). Amongst 2946
incident scleritis patients, 62·2%(n=1831) were female, mean age was
44·9(SD17·6, range 1‐93) years and 88·8%(n=1257) were White. Higher risk of
incident scleritis was associated with female sex (adjusted incidence rate
ratio [aIRR]=1·54, 1·43‐1·66,p<0.001), Black (aIRR=1·52, 1·14‐2·01,p=0.004)
or South Asian race/ethnicity (aIRR=1·50, 1·19‐1·90,p<0.001) versus White,
and older age (peak aIRR=4·95, 3·99‐6·14,p<0.001 for ages 51‐60 years versus
≤10 years). Compared to controls, scleritis patients had 2‐fold increased risk
of prior I‐IMID diagnosis (p<0.001, 17 I‐IMIDs) and significantly increased
risk of subsequent diagnosis of 13 I‐IMIDs. Strongest associations included
granulomatosis with polyangiitis, Behçet’s disease, and Sjögren’s syndrome.
Conclusion
Over 1997‐2018 the UK incidence of scleritis declined from
4·23 to 2·79/100,000 persons/year. Incident scleritis was associated with 19
I‐IMIDs, providing data for rational investigation and cross‐specialty
engagement.
AB - Objective
To estimate 22‐year trends in scleritis prevalence and
incidence and associations with infectious/immune‐mediated inflammatory
diseases (I‐IMIDs) in the United Kingdom (UK).
Methods
Retrospective cross‐sectional and population cohort study
(1997‐2018) included 10,939,823 patients (n=2946 incident scleritis cases) in
The Health Improvement Network (THIN), a nationally‐representative primary care
records database. Case‐control and cohort study (1995‐2019) included 3005
incident scleritis cases and 12,020 control patients matched by age, sex,
region and Townsend Deprivation Index (TDI). We adjusted Poisson, Logistic and
Cox proportional hazard multivariable models by age, sex, TDI, race/ethnicity,
smoking, nation and body mass index category. Estimates include 95% confidence
intervals.
Results
Scleritis incidence rates declined from 4·23(2·16‐6·31) to
2·79(2·19‐3·39) per 100,000 person‐years between 1997 and 2018. Prevalence was
93·62(90·17‐97·07)/100,000 people in 2018 (61,650 UK patients). Amongst 2946
incident scleritis patients, 62·2%(n=1831) were female, mean age was
44·9(SD17·6, range 1‐93) years and 88·8%(n=1257) were White. Higher risk of
incident scleritis was associated with female sex (adjusted incidence rate
ratio [aIRR]=1·54, 1·43‐1·66,p<0.001), Black (aIRR=1·52, 1·14‐2·01,p=0.004)
or South Asian race/ethnicity (aIRR=1·50, 1·19‐1·90,p<0.001) versus White,
and older age (peak aIRR=4·95, 3·99‐6·14,p<0.001 for ages 51‐60 years versus
≤10 years). Compared to controls, scleritis patients had 2‐fold increased risk
of prior I‐IMID diagnosis (p<0.001, 17 I‐IMIDs) and significantly increased
risk of subsequent diagnosis of 13 I‐IMIDs. Strongest associations included
granulomatosis with polyangiitis, Behçet’s disease, and Sjögren’s syndrome.
Conclusion
Over 1997‐2018 the UK incidence of scleritis declined from
4·23 to 2·79/100,000 persons/year. Incident scleritis was associated with 19
I‐IMIDs, providing data for rational investigation and cross‐specialty
engagement.
UR - https://onlinelibrary.wiley.com/journal/23265205
U2 - 10.1002/art.41709
DO - 10.1002/art.41709
M3 - Article
SN - 2326-5191
VL - 73
SP - 1267
EP - 1276
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 7
ER -