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Temporal trends in prevalence, incidence, and mortality for rheumatoid arthritis in Quebec, Canada: a population-based study

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Abstract

Health administrative data are a potentially efficient resource to conduct population-based research and surveillance, including trends in incidence and mortality over time. Our objective was to explore time trends in incidence and mortality for rheumatoid arthritis (RA), as well as estimating period prevalence. Our RA case definition was based on one or more hospitalizations with a RA diagnosis code, or three or more RA physician-billing codes, over 2 years, with at least one RA billing code by a rheumatologist, orthopedic surgeon, or internist. To identify incident cases, a “run-in” period of 5 years (1996–2000) was used to exclude prevalent cases. Crude age and sex-specific incidence rates were calculated (using data from 2001 to 2015), and sex-specific incidence rates were also standardized to the 2001 age structure of the Quebec population. We linked the RA cohort (both prevalent and incident patients) to the vital statistics registry, and standardized mortality rate ratios were generated. Negative binomial regression was used to test for linear change in standardized incidence rates and mortality ratios. The linear trends in standardized incidence rates did not show significant change over the study period. Mortality in RA was significantly higher than the general population and this remained true throughout the study period. Our prevalence estimate suggested 0.8% of the Quebec population may be affected by RA. RA incidence appeared relatively stable, and mortality was substantially higher in RA versus the general population and remained so over the study period. This suggests the need to optimize long-term RA outcomes.

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Authors and Affiliations

  1. National Institute of Public Health of Québec, Québec, Canada

    Sonia Jean & Philippe Gamache

  2. Laval University, Québec, Canada

    Sonia Jean, Louis Bessette & Paul R. Fortin

  3. Jewish General Hospital and Lady Davis Institute for Medical Research, Montréal, Canada

    Marie Hudson

  4. Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montréal, Canada

    Marie Hudson & Sasha Bernatsky

  5. Centre hospitalier universitaire de Québec (CHUQ) Research Centre – Centre hospitalier de l’Université Laval (CHUL), Québec, Canada

    Louis Bessette & Paul R. Fortin

  6. University of Sherbrooke, Sherbrooke, Canada

    Gilles Boire

  7. Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, 687 Pine Avenue West, V-Building, Room V2.09, Montreal, Quebec, H3A 1A1, Canada

    Sasha Bernatsky

Authors
  1. Sonia Jean
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  2. Marie Hudson
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  3. Philippe Gamache
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  4. Louis Bessette
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  5. Paul R. Fortin
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  6. Gilles Boire
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  7. Sasha Bernatsky
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Corresponding author

Correspondence to Sasha Bernatsky.

Ethics declarations

The creation of this surveillance system was approved by the government bodies in legal possession of the databases, the public health ethics committee, and the Access to Information Office in Quebec.

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Highlights

• Health administrative data are a potentially efficient resource to conduct population-based research and surveillance, including trends in incidence and mortality over time; our objective was to explore time trends in incidence and mortality for rheumatoid arthritis (RA).

• We found that mortality was substantially higher in RA versus the general population and remained so over the study period. This suggests the need to optimize long-term RA outcomes.

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Jean, S., Hudson, M., Gamache, P. et al. Temporal trends in prevalence, incidence, and mortality for rheumatoid arthritis in Quebec, Canada: a population-based study. Clin Rheumatol 36, 2667–2671 (2017). https://doi.org/10.1007/s10067-017-3796-1

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  • DOI: https://doi.org/10.1007/s10067-017-3796-1

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