Prevalence and Incidence of Rheumatoid Arthritis in Canadian First Nations and Non–First Nations People

Hitchon, Carol; Khan, Sazzadul; Elias, Brenda; Lix, Lisa M.; Peschken, Christine A.

doi:10.1097/rhu.0000000000001006

Cited by 33 publications

(21 citation statements)

References 32 publications

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“…First, we applied a validated case definition to identify all Manitoba residents with RA during the study period (see , available on the Arthritis Care & Research web site at http://onlinelibrary.wiley.com/doi/10.1002/acr.23539/abstract) . This case definition has a sensitivity of 77.12% and a specificity of 90.3% as compared to physician‐recorded diagnoses in a database . We restricted the analysis to incident cases of RA by excluding cases with any health claims for 5 years before the date of the first health claim for RA (index [diagnosis] date); therefore, the earliest incident cases had an index year of 1989.…”

Section: Methodsmentioning

confidence: 99%

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Marrie

Hitchon

Walld

et al. 2018

Arthritis Care & Research

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117

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ObjectiveWe estimated the incidence and prevalence of depression, anxiety disorder, bipolar disorder, and schizophrenia in a population‐based cohort with rheumatoid arthritis (RA) as compared to an age‐, sex‐, and geographically matched cohort without RA.MethodsUsing population‐based administrative health data from Manitoba, Canada, we identified persons with incident RA between 1989 and 2012, and a cohort from the general population matched 5:1 on year of birth, sex, and region of residence. We applied validated algorithms for depression, anxiety disorder, bipolar disorder, and schizophrenia to determine the annual incidence of these conditions after the diagnosis of RA, and their lifetime and annual period prevalence. We compared findings between cohorts using negative binomial regression models.ResultsWe identified 10,206 incident cases of RA and 50,960 matched individuals. After adjustment for age, sex, socioeconomic status, region of residence, number of physician visits, and year, the incidence of depression was higher in the RA cohort over the study period (incidence rate ratio [IRR] 1.46 [95% confidence interval (95% CI) 1.35–1.58]), as was the incidence of anxiety disorder (IRR 1.24 [95% CI 1.15–1.34]) and bipolar disorder (IRR 1.21 [95% CI 1.00–1.47]). The incidence of schizophrenia did not differ between groups (IRR 0.96 [95% CI 0.61–1.50]). Incidence rates of psychiatric disorders declined minimally over time. The lifetime and annual period prevalence of depression and anxiety disorder were also higher in the RA than in the matched cohort over the study period.ConclusionThe incidence and prevalence of depression, anxiety disorder, and bipolar disorder are elevated in the RA population as compared to a matched population.

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Section: Methodsmentioning

confidence: 99%

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Marrie

Hitchon

Walld

et al. 2018

Arthritis Care & Research

Self Cite

117

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“…Indigenous North Americans have some of the highest rates of RA worldwide, with varying estimated rates of incidence and prevalence reported among different Indigenous North American populations . A recent analysis from a large administrative database in Manitoba, Canada showed the prevalence of RA in an Indigenous North American population to be 0.9%, compared to 0.6% in a non‐Indigenous North American population . In a southeast Alaska Indigenous North American population, the prevalence of RA is estimated to be 2.4%, with incidence rates of 46/100,000 males per year and 122/100,000 females per year .…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of the Development of Inflammatory Arthritis in the Family Members of Indigenous North American People With Rheumatoid Arthritis

Tanner

Dufault

Smolik

et al. 2019

Arthritis & Rheumatology

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Objective To determine the incidence of inflammatory arthritis and autoantibody prevalence in Indigenous North American people. Methods Unaffected relatives of Indigenous North Americans with rheumatoid arthritis (RA) from central Canada and Alaska were systematically monitored from 2005 to 2017. Rheumatoid factor (RF) and anti–citrullinated protein antibodies (ACPAs) were tested at every visit, and a subset was tested for ACPA fine specificity using a custom multiplex assay. Multistate models based on all available study visits were developed to determine the likelihood of transitioning between autoantibody states, or to inflammatory arthritis. Results Eighteen of 374 relatives (4.8%) developed inflammatory arthritis during follow‐up (after a mean ± SD of 4.7 ± 2.4 years), yielding a transition rate of 9.2 cases/1,000 person‐years. Thirty percent of those who developed inflammatory arthritis were seronegative at baseline, but all were seropositive at inflammatory arthritis onset. Although 30% of ACPA/RF double‐seropositive individuals developed inflammatory arthritis (after 3.2 ± 2.2 years), the majority of these individuals did not develop inflammatory arthritis. Multistate modeling indicated a 71% and 68% likelihood of ACPA and RF seropositive states, respectively, reverting to a seronegative state after 5 years, and a 39% likelihood of an ACPA/RF double‐seropositive state becoming seronegative. Fine specificity testing demonstrated an expansion of the ACPA repertoire prior to the development of inflammatory arthritis. Conclusion Despite a high incidence of inflammatory arthritis in this cohort of at‐risk relatives of Indigenous North Americans with RA, a large proportion of autoantibody‐positive individuals do not develop inflammatory arthritis and revert back to an autoantibody‐negative state.

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“…Study populations. Using validated case definitions, we first identified Manitobans with RA (16). For each case, the first health claim with an RA diagnosis constituted the index date.…”

Section: Methodsmentioning

confidence: 99%

Impact of Psychiatric Comorbidity on Health Care Use in Rheumatoid Arthritis: A Population‐Based Study

Hitchon

Walld

Peschken

et al. 2020

Arthritis Care & Research

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Objective. Psychiatric comorbidity is frequent in rheumatoid arthritis (RA) and complicates treatment. The present study was undertaken to describe the impact of psychiatric comorbidity on health care use (utilization) in RA. Methods. We accessed administrative health data (1984-2016) and identified a prevalent cohort with diagnosed RA. Cases of RA (n = 12,984) were matched for age, sex, and region of residence with 5 controls (CNT) per case (n = 64,510). Within each cohort, we identified psychiatric morbidities (depression, anxiety, bipolar disorder, and schizophrenia [PSYC]), with active PSYC defined as ≥2 visits per year. For the years 2006-2016, annual rates of ambulatory care visits (mean ± SD per person) categorized by provider (family physician [FP], rheumatologist, psychiatrist, other specialist), hospitalization (% of cohort), days of hospitalization (mean ± SD), and dispensed drug types (mean ± SD per person) were compared among 4 groups (CNT, CNT plus PSYC, RA, and RA plus PSYC) using generalized linear models adjusted for age, sex, rural versus urban residence, income quintile, and total comorbidities. Estimated rates are reported with 95% confidence intervals (95% CIs). We tested within-person and RA-PSYC interaction effects. Results. Subjects with RA were mainly female (72%) and urban residents (59%), with a mean ± SD age of 54 ± 16 years. Compared to RA without PSYC, RA with PSYC had more than additive (synergistic) visits (standardized mean difference [SMD] 10.92 [95% CI 10.25, 11.58]), hospitalizations (SMD 13% [95% CI 0.11, 0.14]), and hospital days (SMD 3.63 [95% CI 3.06, 4.19]) and were dispensed 6.85 more medication types (95% CI 6.43, 7.27). Cases of RA plus PSYC had increased visits to FPs (an additional SMD 8.92 [95% CI 8.35, 9.46] visits). PSYC increased utilization in within-person models. Conclusion. Managing psychiatric comorbidity effectively may reduce utilization in RA.

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Prevalence and Incidence of Rheumatoid Arthritis in Canadian First Nations and Non–First Nations People

Cited by 33 publications

References 32 publications

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

Increased Burden of Psychiatric Disorders in Rheumatoid Arthritis

A Prospective Study of the Development of Inflammatory Arthritis in the Family Members of Indigenous North American People With Rheumatoid Arthritis

Impact of Psychiatric Comorbidity on Health Care Use in Rheumatoid Arthritis: A Population‐Based Study

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