背景:幼年特发性关节炎(JIA)描述了儿童和青少年不明原因的慢性炎症性风湿性疾病的异质性类别。文献中的流行病学数据各不相同,根据地理位置,种族和使用的案例定义。我们评估了流行病学,特别是国际风湿病协会联盟(ILAR)定义的类别。
方法:从1月1日起使用来自两个不同的纵向健康声明数据库(WIG2和InGef)的数据,2013年12月31日,2019年,我们研究了2至15岁的患者,在一个日历年内至少两个不同的季度中,至少有一名主要住院患者或两名二级住院/验证门诊ICD-10诊断。我们计算了患病率和发病率(每100,000名患者),并将数据外推到整个德国人口,观察性别和年龄组的差异。此外,我们收集了JIA患者人群中的“其他”非必需合并症的数据.
结果:在2018年数据库中(分别)的3-4百万患者中,我们发现总共546名(WIG2)和849名(InGef)患者符合我们的JIA病例定义,发病率为34(29-41)和60(53-67),患病率为133(122-145)和168(157-179)。女性在整个年龄段的发病率和患病率大多高于男性,然而,女性和男性之间的差异随着年龄的增长而增加。在ILAR类别中,少关节炎是最普遍的(70和91/100,000),大约一半的JIA患者属于这一类,其次是未分化关节炎(49和56例/100,000)和类风湿因子阴性(RF-)(31和39/100,000)。2018年的发病率是这三个类别中最高的。特应性皮炎,血管舒缩和过敏性鼻炎,葡萄膜炎是两种数据库中最常见的预定义合并症.
结论:本研究提供了德国JIA的当前发病率和患病率数据,有助于了解疾病负担和医疗保健规划工具。
BACKGROUND: Juvenile idiopathic arthritis (
JIA) describes heterogenous categories of chronic inflammatory rheumatic conditions of unknown origin in children and adolescents. Epidemiological data in the literature vary, depending on geographic location, ethnicity and the case definition used. We evaluated epidemiology, especially that of the categories defined by the International League of Associations for Rheumatology (ILAR).
METHODS: Using data from two different longitudinal health claims databases (WIG2 and InGef) from January 1st, 2013 to December 31st, 2019, we looked at patients aged 2 to 15 years old with at least one main inpatient or two secondary inpatient/verified outpatient ICD-10 diagnoses in at least two different quarters within one calendar year. We calculated prevalence and incidence (per 100,000 patients) and extrapolated data to the entire German population, looking at differences in gender and age groups. Additionally, we collected data on \"other\" not necessary comorbidities in our
JIA patient population.
RESULTS: Of the 3-4 million patients in the databases (respectively) in 2018, we found a total of 546 (WIG2) and 849 (InGef) patients that met our
JIA case definition, with an incidence of 34 (29-41) and 60 (53-67) and prevalence of 133 (122-145) and 168 (157-179). Both incidence and prevalence throughout the age range were mostly higher in females than males, however the difference between females and males increased with increasing age. Of the ILAR categories, oligoarthritis was the most prevalent (70 and 91 per 100,000), with about half of our
JIA patients in this category, followed by undifferentiated arthritis (49 and 56 cases per 100,000) and rheumatoid factor negative (RF-) (31 and 39 per 100,000). Incidence in 2018 was the highest in these three categories. Atopic dermatitis, vasomotor and allergic rhinitis, and uveitis were the pre-defined comorbidities seen most often in both databases.
CONCLUSIONS: This
study provides current incidence and prevalence
JIA data in Germany, contributing to knowledge on burden of disease and tools for healthcare planning.