Increasing Prevalence of RA, PsA and AS in the UK Save

Electronic health record (EHR) database analysis from the United Kingdom suggests an increasing number of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritits (SpA) patients in England.

The incidence and prevalence of RA, PsA, and axial SpA in primary care was drawn from the Clinical Practice Research Datalink Aurum, an electronic health record (EHR) database covering ∼20% of England. These diagnoses were verified by algorithms to confirm diagnosis and updated diagnosis and synthetic disease-modifying anti-rheumatic drug use by rheumatologists and general practitioners was ascertained. The annual incidence/point-prevalence of RA, PsA, and axial SpA diagnoses from 2004 to 2020 was calculated.

The Point-prevalence of RA/PsA diagnoses increased annually:

• RA = 0·779%  (peaked in 2019; falling slightly since)
• PsA = 0·287% (peaked in 2019; falling slightly since) 
• axial SpA diagnoses = 0·113% (increased annually, except in 2018/2019, peaking in 2020)

The annual incidence of RA increased in eras from 2004-2012 (34.5-40 per 100,000 person-years) to 2013-2019 (49·1-50·5 per 100,000 person-years) after targeting RA as a quality improvement diagnosis. Similarly, the annual incidence of PsA/axial SpA diagnosis rose following new classification criteria publication.

After 2019 and 2020, the annual incidence of RA, PsA and axial SpA diagnoses fell by 40·1%, 67·4%, and 38·1%, presumeably reflecting the COVID-19 pandemic's impact on diagnosis.

Public health measures and greater awareness contributed to the rising diagnoses of inflammatory arthritis in the UK, underscoring the of organising healthcare services to provide timely and optimal care.