■虽然原发性胆汁性胆管炎(PBC)被认为是一种罕见的疾病,由于以人群为基础的综合性登记处有限,准确确定其发病率和流行率仍然具有挑战性.我们旨在通过全国性的荷兰PBC队列研究(DPCS)评估荷兰PBC的发病率和患病率。
■DPCS回顾性地纳入了从1990年起荷兰所有71家医院的所有可识别的PBC患者。在2008-2018年间,通过Poisson回归评估了性别和年龄组之间的发病率和患病率。
■2008年1月1日,荷兰有1,458名PBC患者。在2008年至2018年期间,新诊断出2187人,46例移植,468例死亡。2008年PBC的年发病率为1.38,2018年增加到每10万人1.74。与年龄<45岁的人相比,年龄45-64岁的女性(校正后发生率4.21,95%CI3.76-4.71,p<0.001)和年龄≥65岁的男性(校正后发生率14.41,95%CI9.62-21.60,p<0.001)被诊断为PBC的风险最高.在研究期间,新诊断为PBC的患者在<45岁时的男女比例为1:14,1:10在45-64岁的患者中,在≥65岁时为1:4。点患病率从2008年的11.9增加到2018年的21.5/10万人。该时间段的平均年变化百分比为5.94%(95%CI5.77-6.15,p<0.05),在65岁以上的人群中最高(5.69%,95%CI5.32-6.36,p<0.001)。
■在这项全国性的队列研究中,我们观察到在过去的十年中,荷兰的PBC的发病率和患病率都有所增加,有明显的年龄和性别差异。
■这项全国性的荷兰原发性胆汁性胆管炎(PBC)队列研究,包括荷兰的所有医院,表明PBC的发病率和患病率在过去十年中有所增加。男性(最高风险≥65岁)和女性(最高风险在45至65岁之间)的年龄依赖性PBC发病率有所不同。这可能与PBC暴露于环境触发因素的时间差异有关。在65岁以上的人群中,PBC患病率随时间的增长最大。这可能对二线治疗的使用有影响。因此,这些结果表明,需要进一步的研究来阐述老年人群附加疗法的优缺点。
UNASSIGNED: Although primary biliary cholangitis (PBC) is considered a rare disorder, accurate determination of its incidence and prevalence remains challenging due to limited comprehensive population-based registries. We aimed to assess the incidence and prevalence of PBC in the Netherlands over time through the nationwide Dutch PBC Cohort Study (DPCS).
UNASSIGNED: DPCS retrospectively included every identifiable patient with PBC in the Netherlands from 1990 onwards in all 71 Dutch hospitals. Incidence and prevalence were assessed between 2008-2018 by Poisson regression between sex and age groups over time.
UNASSIGNED: On the 1st of January 2008, there were 1,458 patients with PBC in the Netherlands. Between 2008-2018, 2,187 individuals were newly diagnosed, 46 were transplanted and 468 died. The yearly incidence of PBC in 2008 was 1.38, increasing to 1.74 per 100,000 persons in 2018. When compared to those aged <45 years, females aged 45-64 years (adjusted incidence rate ratio 4.21, 95% CI 3.76-4.71, p <0.001) and males ≥65 years (adjusted incidence rate ratio 14.41, 95% CI 9.62-21.60, p <0.001) were at the highest risk of being diagnosed with PBC. The male-to-female ratio of patients newly diagnosed with PBC during the study period was 1:14 in those <45 years, 1:10 in patients aged 45-64 years, and 1:4 in those ≥65 years. Point prevalence increased from 11.9 in 2008 to 21.5 per 100,000 persons in 2018. Average annual percent change in this time period was 5.94% (95% CI 5.77-6.15, p <0.05), and was the highest among the population aged ≥65 years (5.69%, 95% CI 5.32-6.36, p <0.001).
UNASSIGNED: In this nationwide cohort study, we observed an increase in both the incidence and prevalence of PBC in the Netherlands over the past decade, with marked age and sex differences.
UNASSIGNED: This nationwide Dutch primary biliary cholangitis (PBC) Cohort Study, including all hospitals in the Netherlands, showed that the incidence and prevalence of PBC have increased over the last decade. The age-dependent PBC incidence rate differed for males (highest risk ≥65 years) and females (highest risk between 45 and 65 years), which may be related to a difference in the timing of exposure to environmental triggers of PBC. The largest increase in PBC prevalence over time was observed in the population aged ≥65 years, which may have implications for the use of second-line therapies. These results therefore indicate that further studies are needed to elaborate on the advantages and disadvantages of add-on therapies in the elderly population.