POS0025 INCIDENCE RATES AND POINT PREVALENCE OF SEROPOSITIVE AND SERONEGATIVE RHEUMATOID ARTHRITIS IN DENMARK: A NATIONWIDE REGISTER-BASED STUDY FROM 1998 TO 2018 USING FOUR DIFFERENT CASE CRITERIA
Authors: B. G. Soussi, R. L. Cordtz, S. Kristensen, C. S. Bork, J. Christensen, E. B. Schmidt, D. Prieto-Alhambra, L. Dreyer
Journal: Annals of the Rheumatic Diseases (2021)

Background: Few previous studies have investigated the incidence rate (IR) and point prevalence (PP) of seropositive and seronegative rheumatoid arthritis (RA), and further, the estimates remain unknown in the Danish population. Objectives: To investigate the IR and PP of seropositive and seronegative RA in the adult Danish population from 1998 to 2018 using four register-based case definitions of RA. Methods: Nationwide register-based cohort study. Using the Danish administrative registers, patients with RA between 1998 and end of 2018 were identified. ICD-10 codes for RA were identified in the Danish National Patient Registry and information on DMARD prescriptions were obtained through the Danish National Prescription Registry using ATC codes. The used case definitions were 1 : Criteria A, first time M05/M06 RA diagnosis and redemption of a DMARD in the following year; Criteria B, two RA diagnoses within 90 days of each other, originating from department of rheumatology or general internal medicine, where the latest registered M05/M06 diagnosis defined the serologic status; Criteria C, a M05/M06 diagnosis recorded at any time preceded or followed by redemption of a DMARD prescription within one year, where the M05/M06 diagnosis recorded determined the serologic status; Criteria D, as Criteria A, but with the additional requirements that cases had no registration for other selected inflammatory diseases. In calculation of IRs the total Danish population from 1998 to 2018 was used as reference population for standardisation. The PP was calculated for years 2000, 2009, 2011 and 2018. Results: From 1998 to 2018 the overall IR was 18.0 (95%CI 17.7 to 18.3) per 100,000 person years (PY) for seropositive RA and 16.7 (95%CI 16.4 to 16.9) per 100,000 PY for seronegative RA using Criteria A. A higher IR for seropositive RA than for seronegative RA was found regardless of the case criteria used. Figure 1 shows the temporal IRs of seropositive and seronegative RA. Regardless of case criteria used, the PP increased from 2000 to 2018 for both seropositive and seronegative RA, and the estimates were higher for seropositive RA than for seronegative RA (Table 1). Table 1. Point prevalence of rheumatoid arthritis in Denmark in year 2000, 2009, 2011 and 2018 using four different case definitions 2000 2009 2011 2018 Seropositive Seronegative Seropositive Seronegative Seropositive Seronegative Seropositive Seronegative Criteria A N 3029 2741 7474 7127 8712 8121 12437 11662 Population 3964040 4166298 4202891 4269677 PP, % (95%CI ) 0.08 (0.08 to 0.08) 0.07 (0.07 to 0.07) 0.18 (0.18 to 0.19) 0.17 (0.17 to 0.18) 0.21 (0.20 to 0.21) 0.19 (0.19 to 0.20) 0.27 (0.27 to 0.28) 0.26 (0.25 to 0.26) Criteria B N 7507 4893 11565 9033 12710 10011 16334 13340 PP, % (95%CI ) 0.20 (0.19 to 0.20) 0.13 (0.12 to 0.13) 0.28 (0.28 to 0.29) 0.22 (0.21 to 0.22) 0.30 (0.30 to 0.31) 0.24 (0.23 to 0.24) 0.36 (0.35 to 0.36) 0.29 (0.29 to 0.30) Criteria C N 6701 4570 11174 9125 12417 10149 15881 13712 PP, % (95%CI ) 0.18 (0.17 to 0.18) 0.12 (0.12 to 0.12) 0.27 (0.27 to 0.28) 0.22 (0.22 to 0.23) 0.29 (0.29 to 0.30) 0.24 (0.24 to 0.25) 0.35 (0.34 to 0.35) 0.30 (0.30 to 0.31) Criteria D N 2724 2390 6612 5984 7695 6759 10830 9452 PP, % (95%CI ) 0.07 (0.07 to 0.07) 0.06 (0.06 to 0.07) 0.16 (0.16 to 0.16) 0.15 (0.14 to 0.15) 0.18 (0.18 to 0.19) 0.16 (0.16 to 0.17) 0.24 (0.23 to 0.24) 0.21 (0.20 to 0.21) PP = Point prevalence Conclusion: In Denmark, the IR and PP estimates were higher for seropositive compared to seronegative RA during the study period. However, when applying stricter case criteria for RA (Criteria A and D) the differences in IR and PP estimates were smaller, than when using less strict criteria (Criteria B and C). The findings of such small differences between seropositive and seronegative IRs warrant further investigation. References: [1]Soussi BG et al. Incidence and prevalence of rheumatoid arthritis in Denmark: a nationwide population based study investigating the effect of four different case definitions [abstract]. Ann Rheum Dis. 2020;79(supplement 1):46 Acknowledgements: The authors will like to thank The Danish Rheumatism Association for supporting this work. Disclosure of Interests: Bolette Gylden Soussi: None declared, René Lindholm Cordtz: None declared, Salome Kristensen: None declared, Christian Sørensen Bork: None declared, Jeppe Christensen: None declared, Erik Berg Schmidt: None declared, Daniel Prieto-Alhambra Grant/research support from: Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums, and Synapse Management Partners have supported training programmes organised by DPA’s department and open for external participants, Lene Dreyer Grant/research support from: Grants from BMS, Galderma and Eli Lilly.