Epidemiology of scleritis in the United Kingdom from 1997 to 2018: population-based analysis of 11 million patients and association between scleritis and infectious and immune-mediated inflammatory disease

Research output: Contribution to journalArticlepeer-review

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{71238e1d3f0f471c9408a7f093cb42db,
title = "Epidemiology of scleritis in the United Kingdom from 1997 to 2018: population-based analysis of 11 million patients and association between scleritis and infectious and immune-mediated inflammatory disease",
abstract = "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, Beh{\c c}et{\textquoteright}s disease, and Sj{\"o}gren{\textquoteright}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.",
author = "Tasanee Braithwaite and Nicola Adderley and Anuradhaa Subramanian and James Galloway and Kempen, {John H.} and Krishna Gokhale and Cope, {Andrew P} and Dick, {Andrew D.} and Krishnarajah Nirantharakumar and Alastair Denniston",
year = "2021",
month = mar,
day = "16",
doi = "10.1002/art.41709",
language = "English",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "Wiley",

}

RIS

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

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

ER -