The Epidemiology of Rheumatoid Arthritis in Ontario, Canada

Widdifield, Jessica; Paterson, J. Michael; Bernatsky, Sasha; Tu, Karen; Tomlinson, George; Kuriya, Bindee; Thorne, John; Bombardier, Claire

doi:10.1002/art.38306

Cited by 107 publications

(86 citation statements)

References 32 publications

(52 reference statements)

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“…However, that was a systematic review of published studies, which would have different observation periods for each study, hence it would be difficult to determine the temporal change. This contrasts with studies from Ontario, Canada [27], and Rochester, NY, USA [13], where the prevalence of RA increased over time, with no reduction in recent years. Further research is required to explore factors underlying this, but this could include migration and mortality.…”

Section: Discussioncontrasting

confidence: 59%

Rheumatoid arthritis is getting less frequent—results of a nationwide population-based cohort study

et al. 2017

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Objectives. The objectives of this study were to examine changes in the incidence and prevalence of RA between 1990 and 2014 and to explore if there is any geographic variation in the incidence and prevalence of RA in the UK.Methods. This was a primary carebased prospective cohort study. People contributing acceptable data to Clinical Practice Research Datalink between 1 January 1990 and 31 December 2014 were included. Read codes were used to identify RA cases 518 years of age. The prevalence and incidence rates for each year were standardized to the 2014 population and the regional incidence and prevalence of RA for the year 2014 were standardized to the overall population.Results. The incidence and prevalence of RA was 3.81/10 000 person-years and 0.67%, respectively, in 2014. The annual incidence of RA decreased by 1.6% (95% CI 0.8, 2.5) between 1990 and 2014, with significant joinpoints at 1994 and 2002. The prevalence of RA increased by 3.7%/year (95% CI 3.2, 4.1) from 1990 to 2005 and decreased by 1.1%/year (95% CI 2.0, 0.2) between 2005 and 2014. There were significant differences in the occurrence of RA throughout different regions of the UK, with the highest incidence in East Midlands, Yorkshire and Humber and the highest prevalence in North East, Yorkshire and Humber.Conclusion. The incidence of RA is decreasing, with a reduction in prevalence in recent years. There is significant geographic variation in the occurrence of RA in the UK. Further research is required to identify the reasons underlying this phenomenon so that public health interventions can be designed to further reduce the incidence of RA.

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Section: Discussioncontrasting

confidence: 59%

Rheumatoid arthritis is getting less frequent—results of a nationwide population-based cohort study

et al. 2017

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“…Despite the increasing RA burden over the past decade, the number of rheumatologists in Ontario has remained relatively stable at 160, or 1.5 rheumatologists per 100,000 population (Widdifield et al 2014b). Moreover, few rheumatologists are located in northern communities where RA prevalence is high (Widdifield et al 2014b).…”

Section: Ra Burden and Epidemiologymentioning

confidence: 99%

“…Moreover, few rheumatologists are located in northern communities where RA prevalence is high (Widdifield et al 2014b). Despite the shortage, access to rheumatologists has improved among patients newly diagnosed with RA (Widdifield et al 2014c).…”

Section: Ra Burden and Epidemiologymentioning

confidence: 99%

Rheumatoid Arthritis Surveillance in Ontario: Monitoring the Burden, Quality of Care and Patient Outcomes through Linkage of Administrative Health Data

Widdifield

Bernatsky

Bombardier

et al. 2015

hcq

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Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Using the Ontario administrative health data housed at the Institute for Clinical Evaluative Sciences, researchers have quantified the population-level burden and epidemiology of RA, mapped its geographic distribution in relation to rheumatologist supply, studied trends in access to rheumatology care and treatment and evaluated patient outcomes. The findings highlight the excess morbidity and mortality associated with the growing burden of RA in the face of a strained rheumatology supply, and raise urgent questions about how best to meet the needs of Ontarians with RA.

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“…RA is distributed in all ethnic groups with a low degree of variance. According to a recent review, the annual incidence of RA has been reported to be around 40/100,000 worldwide; as many other autoimmune conditions, the disease affects more frequently women by a 2:1 to 3:1 ratio [7][8][9][10]. Overall the lifetime risk of RA in adults is 3.6 percent (1 in 28) for women and 1.7 percent (1 in 59) for men [11].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of anti-citrullinated peptide antibodies: a real life experience

et al. 2014

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Rheumatoid Arthritis (RA) is an autoimmune destructive joint disease, characterized by the presence of rheumatoid factor and anti-citrullinated peptide antibodies. Anti-citrullinated peptide antibodies were recently defined as RA criterion with sensitivity and specificity of 50-80 and 75-95 %, respectively. However, in the general population, the predictive value of anti-citrullinated peptide antibodies is yet to be determined. Herein, we aim to determine the predictive value of anti-citrullinated peptide antibodies in real life as well as clinical and serological factors related to this value. Retrospective cross-sectional study of consecutive samples evaluated for anti-citrullinated peptide antibodies in a referral autoimmune laboratory. Demographic and clinical parameters at the time the sample was drawn were collected. During November 2011 through December 2013, a total of 215 anti-citrullinated peptide antibody tests were performed in our laboratory. Data were available for 140 samples of which only 28 samples were positive for anti-citrullinated peptide antibodies. Of the 140 patients tested, 18 were diagnosed with RA, of which 12 were positive and 6 were negative for anti-citrullinated peptide antibody test. Thus, in this cohort, anti-citrullinated peptide antibodies were positive in 20 % of samples with a positive predictive value (PPV) of 43 % and a negative predictive value of 95 %. In real life, only 20 % of anti-citrullinated peptide antibody tests referred to a tertiary center where found to be positive. The negative predictive value of this test is very high and may support the common use of anti-citrullinated peptide antibody test as an exclusion criterion in the process of evaluating a patient with rheumatic disease.

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The Epidemiology of Rheumatoid Arthritis in Ontario, Canada

Cited by 107 publications

References 32 publications

Rheumatoid arthritis is getting less frequent—results of a nationwide population-based cohort study

Rheumatoid arthritis is getting less frequent—results of a nationwide population-based cohort study

Rheumatoid Arthritis Surveillance in Ontario: Monitoring the Burden, Quality of Care and Patient Outcomes through Linkage of Administrative Health Data

Predictive value of anti-citrullinated peptide antibodies: a real life experience

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