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Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis : Results from a national register-based cohort study

Bengtsson, Karin ; Forsblad-D'Elia, Helena ; Deminger, Anna ; Klingberg, Eva ; Dehlin, Mats ; Exarchou, Sofia LU ; Lindström, Ulf ; Askling, Johan and Jacobsson, Lennart T.H. (2021) In Rheumatology (United Kingdom) 60(6). p.2725-2734
Abstract

Objectives: To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods: Three mutually exclusive cohorts of patients aged 18-69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001-2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016.... (More)

Objectives: To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods: Three mutually exclusive cohorts of patients aged 18-69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001-2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results: Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions: AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anterior uveitis, extra-articular manifestations, inflammatory bowel disease, psoriasis, Spondyloarthritis
in
Rheumatology (United Kingdom)
volume
60
issue
6
pages
10 pages
publisher
Oxford University Press
external identifiers
  • pmid:33216939
  • scopus:85102776710
ISSN
1462-0324
DOI
10.1093/rheumatology/keaa692
language
English
LU publication?
yes
id
8a3fcc3c-843d-4c4d-b477-f674a8d47e20
date added to LUP
2022-02-22 13:21:49
date last changed
2024-09-05 19:06:05
@article{8a3fcc3c-843d-4c4d-b477-f674a8d47e20,
  abstract     = {{<p>Objectives: To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods: Three mutually exclusive cohorts of patients aged 18-69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001-2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results: Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions: AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD. </p>}},
  author       = {{Bengtsson, Karin and Forsblad-D'Elia, Helena and Deminger, Anna and Klingberg, Eva and Dehlin, Mats and Exarchou, Sofia and Lindström, Ulf and Askling, Johan and Jacobsson, Lennart T.H.}},
  issn         = {{1462-0324}},
  keywords     = {{anterior uveitis; extra-articular manifestations; inflammatory bowel disease; psoriasis; Spondyloarthritis}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{2725--2734}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (United Kingdom)}},
  title        = {{Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis : Results from a national register-based cohort study}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keaa692}},
  doi          = {{10.1093/rheumatology/keaa692}},
  volume       = {{60}},
  year         = {{2021}},
}