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      La prevalencia de diez enfermedades inflamatorias inmunomediadas (IMID) en España Translated title: Prevalence of ten Immune-mediated inflammatory diseases (IMID) in Spain

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      , , , , , , , , , , , , , , ,
      Revista Española de Salud Pública
      Ministerio de Sanidad, Consumo y Bienestar social
      Transversal study, Immune-mediated inflammatory diseases, Rheumatoid arthritis, Psoriasis, Psoriatic arthritis, Ankylosing spondylitis, Ulcerative colitis, Crohn’s disease, Systemic lupus erythematosus, Estudio transversal, Enfermedades inflamatorias inmunomediadas, Artritis reumatoide, Psoriasis, Artritis psoriásica, Espondilitis anquilosante, Colitis ulcerosa, Enfermedad de Crohn, Lupus eritematoso sistémico

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          Abstract

          RESUMEN Fundamentos: Las enfermedades inflamatorias inmunomediadas (IMID) son enfermedades crónicas y altamente discapacitantes que comparten secuencias inflamatorias y desregulaciones inmunológicas. Considerada como una enfermedad en sí, la prevalencia de la IMID es prácticamente desconocida. El objetivo de este trabajo fue valorar la prevalencia de 10 IMID seleccionadas, incluyendo artritis reumatoide, psoriasis, artritis psoriásica, espondilitis anquilosante, colitis ulcerosa, enfermedad de Crohn, lupus eritematoso sistémico, hidrosadenitis supurativa, sarcoidosis y uveítis en España. Métodos: Se hizo un estudio epidemiológico transversal de prevalencia puntual. Este estudio llevó a cabo a través de una serie de entrevistas informatizadas en hogares elegidos al azar en 17 comunidades autónomas en España. Mediante un cuestionario estructurado se determinó la frecuencia de diagnóstico y las concurrencias de 10 IMID en los encuestados y otros individuos pertenecientes al mismo núcleo familiar. Las estimaciones de prevalencia puntual se utilizaron y compararon con el objetivo de determinar la frecuencia de IMID por edad, sexo y comunidades. Los datos fueron procesados utilizando el programa Excel 2016 (Microsoft, Redmond, WA, USA) y el sistema SPSS V.019 (IBM Corp. Armonk, NY, USA) para el análisis estadístico utilizando los test estadísticos habituales en este tipo de estudios. Resultados: De los 7.980 encuestados, 510 fueron diagnosticados con una IMID, lo que representa un estudio transversal de un 6,39% (95% ci: 6,02-6,76). Uno, dos, tres o más miembros de la familia estaban afectados en un 87,2%, 7,8% y 5% de familiares positivos en IMID, respectivamente. Las enfermedades más recurrentes fueron psoriasis (2,69% 95% ci: 2,32-3,06) y artritis reumática (1,07% 95% ci:0,70-1,44). Se observaron diferencias en la prevalencia debidas al sexo (p=0,004) y edad (p=0,000). No se identificaron diferencias significativas relacionadas con la localización geográfica (p=0,819). Se reportó concurrencia de al menos 2 IMID en un 8,9% de encuestados. Conclusiones: La prevalencia global fue de las IMID estudiadas fue del 6,39 % siendo las mas frecuentes la psoriasis con el 2,69%. Este estudio constituye un paso inicial para considerar la IMID como una enfermedad independiente dentro del sistema sanitario.

          Translated abstract

          ABSTRACT Background: Immune-mediated inflammatory diseases (IMID) are chronic and highly disabling diseases that share inflammatory sequences and immunological dysregulations. Considered as a disease in itself, the prevalence of IMID is virtually unknown. The aim of this study was to assess the prevalence of 10 selected UDI, including rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, Crohn’s disease, systemic lupus erythematosus, hidradenitis suppurativa, sarcoidosis and uveitis in Spain. Methods: A cross-sectional epidemiological study of point prevalence was made. This study was carried out through a series of computerized interviews in households chosen at random in 17 autonomous communities in Spain. A structured questionnaire was used to determine the frequency of diagnosis and the concurrence of 10 IMID in the respondents and other individuals belonging to the same family nucleus. The point prevalence estimates were used and compared with the objective of determining the frequency of IMID by age, sex and communities. The data were processed using Excel 2016 (Microsoft, Redmond, WA, USA) and the SPSS V.019 system (IBM Corp. Armonk, NY, USA) for statistical analysis using the usual statistical tests in this type of studies. Results: Of the 7,980 respondents, 510 were diagnosed with an IMID, representing a cross-sectional study of 6.39% (95% CI: 6.02-6.76). One, two, three or more members of the family were affected in 87.2%, 7.8% and 5% of positive relatives in IMID, respectively. The most recurrent diseases were psoriasis (2.69% 95% CI: 2.32-3.06) and rheumatic arthritis (1.07% 95% CI: 0.70-1.44). There were differences in prevalence due to sex (p = 0.004) and age (p = 0.000). No significant differences were identified related to geographic location (p = 0.819). Attendance of at least 2 IMID was reported in 8.9% of respondents. Conclusions: The overall prevalence was of the IMID studied was 6.39%, psoriasis being the most frequent with 2.69%. This study constitutes an initial step to consider IMID as an independent disease within the health system.

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          Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases.

          Previous studies have estimated a prevalence of a broad grouping of autoimmune diseases of 3.2%, based on literature review of studies published between 1965 and 1995, and 5.3%, based on national hospitalization registry data in Denmark. We examine more recent studies pertaining to the prevalence of 29 autoimmune diseases, and use these data to correct for the underascertainment of some diseases in the hospitalization registry data. This analysis results in an estimated prevalence of 7.6-9.4%, depending on the size of the correction factor used. The rates for most diseases for which data are available from many geographic regions span overlapping ranges. We also review studies of the co-occurrence of diseases within individuals and within families, focusing on specific pairs of diseases to better distinguish patterns that may result in insights pertaining to shared etiological pathways. Overall, data support a tendency for autoimmune diseases to co-occur at greater than expected rates within proband patients and their families, but this does not appear to be a uniform phenomenon across all diseases. Multiple sclerosis and rheumatoid arthritis is one disease pair that appears to have a decreased chance of coexistence.
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            Epidemiology of immune-mediated inflammatory diseases: incidence, prevalence, natural history, and comorbidities.

            Immune-mediated inflammatory diseases (IMID) present a group of common and highly disabling chronic conditions that share inflammatory pathways. Several incidence and prevalence studies of IMID during the past decades have reported a considerable variation of the disease occurrence among different populations. Overall, the estimated prevalence of IMID in Western society is 5%-7%. This article provides an overview of studies of the incidence, prevalence, natural history, and comorbidities of IMID.
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              Sarcoidosis incidence and prevalence: a nationwide register-based assessment in Sweden.

              Our objective was to estimate the contemporary incidence and prevalence of sarcoidosis using Swedish population-based register data.Adults with any sarcoidosis-coded visit were identified from the National Patient Register (hospitalisations 1964-2013 and outpatient care 2001-2013). Demographic and medication dispensing data were retrieved from national registers. We estimated the prevalence of sarcoidosis in 2013 overall and by county of residence. The incidence of sarcoidosis during 2003-2012 was estimated by sex, age, education level and year of diagnosis. Case definitions were varied to test their robustness.More than 16 000 individuals had a history of sarcoidosis in 2013. When defined as two or more sarcoidosis-coded visits, the prevalence was 160 per 100 000. Using different definitions, the prevalence ranged from 152 (requiring a specialist visit) to 215 per 100 000 (only one visit required). The highest prevalence was observed in northern less densely populated counties. The incidence was 11.5 per 100 000 per year and varied by -10% to +30% depending on case definition. The incidence peaked in males aged 30-50 years and in females aged 50-60 years, but did not differ by education level and was stable over time.This study represents the largest epidemiological investigation of sarcoidosis using population-based individual-level data. Age at diagnosis in men was 10 years younger than in women and geographical variation was observed.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2019
                : 93
                : e201903013
                Affiliations
                [14] Madrid orgnameServicio Madrileño de Salud orgdiv1Dirección General de Coordinación de la Asistencia Sanitaria España
                [4] Madrid orgnameHospital Universitario Puerta de Hierro-Majadahonda orgdiv1Servicio de Reumatología España
                [16] Madrid Madrid orgnameUniversidad Rey Juan Carlos orgdiv1Medicina Preventiva y Salud Pública Spain
                [10] Valencia orgnameDepartamento de Salud de La Ribera España
                [1] Barcelona orgnameHospital de la Santa Creu i Sant Pau orgdiv1Servicio de Dermatología España
                [5] Barcelona orgnameHospital Clínic de Barcelona orgdiv1Servicio de Enfermedades Autoinmunes Spain
                [2] León orgnameComplejo Hospitalario Universitario de León orgdiv1Servicio de Inmunología España
                [9] Valencia orgnameHospital de Manises orgdiv1Servicio de Medicina Digestiva España
                [6] Barcelona orgnameHospital Clínic de Barcelona orgdiv1Instituto de Oftalmología Spain
                [11] Vitoria-Gasteiz orgnameOsakidetza orgdiv1Dirección General orgdiv2Asistencia Sanitaria España
                [13] Madrid orgnameHospital Nisa Pardo de Aravaca España
                [15] Madrid orgnameConfederación de afectados por Crohn y Colitis Ulcerosa España
                [3] Madrid orgnameHospital Universitario de La Princesa orgdiv1Servicio de Dermatología España
                [12] Madrid orgnameMinisterio de Sanidad orgdiv1Servicios Sociales e Igualdad orgdiv2Calidad y Cohesión España
                [7] Barcelona orgnameHospital Universitari Vall d’Hebron orgdiv1Institut de Recerca orgdiv2Grupo de Investigación de Reumatología España
                [8] Madrid orgnameAsociación de Personas con Enfermedades Crónicas Inflamatorias Inmunomediadas España
                Article
                S1135-57272019000100407 S1135-5727(19)09300000407
                3278f17f-83ee-4468-82e7-fc412e4c3edc

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 22 November 2018
                : 15 October 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 0
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                Ankylosing spondylitis,Psoriasis,Lupus eritematoso sistémico,Ulcerative colitis,Estudio transversal,Colitis ulcerosa,Artritis psoriásica,Artritis reumatoide,Enfermedad de Crohn,Transversal study,Espondilitis anquilosante,Psoriatic arthritis,Enfermedades inflamatorias inmunomediadas,Rheumatoid arthritis,Immune-mediated inflammatory diseases,Systemic lupus erythematosus,Crohn’s disease

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