Global prevalence of ankylosing spondylitis

Linda E. Dean, Gareth T Jones, Alan G MacDonald, Christina Downham, Roger D Sturrock, Gary J Macfarlane

Research output: Contribution to journalArticle

181 Citations (Scopus)

Abstract

OBJECTIVES: For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.

METHODS: A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.

RESULTS: The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.

CONCLUSION: This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.

Original languageEnglish
Pages (from-to)650-657
Number of pages8
JournalRheumatology
Volume53
Issue number4
Early online date9 Dec 2013
DOIs
Publication statusPublished - Apr 2014

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Ankylosing Spondylitis
HLA-B27 Antigen
Latin America
North America
Epidemiologic Studies

Keywords

  • Africa
  • Asia
  • Europe
  • HLA-B27 Antigen
  • Humans
  • Latin America
  • North America
  • Prevalence
  • Spondylitis, Ankylosing
  • World Health
  • Spondyloarthropathies
  • Epidemiology
  • Systematic Review

Cite this

Global prevalence of ankylosing spondylitis. / Dean, Linda E.; Jones, Gareth T; MacDonald, Alan G; Downham, Christina; Sturrock, Roger D; Macfarlane, Gary J.

In: Rheumatology, Vol. 53, No. 4, 04.2014, p. 650-657.

Research output: Contribution to journalArticle

Dean, Linda E. ; Jones, Gareth T ; MacDonald, Alan G ; Downham, Christina ; Sturrock, Roger D ; Macfarlane, Gary J. / Global prevalence of ankylosing spondylitis. In: Rheumatology. 2014 ; Vol. 53, No. 4. pp. 650-657.
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abstract = "OBJECTIVES: For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.METHODS: A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.RESULTS: The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.CONCLUSION: This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.",
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note = "Acknowledgements L.E.D. was supported by a UK Medical Research Council PhD studentship. Disclosure statement: G.T.J., R.D.S. and G.J.M. have received funding from AbbVie Pharmaceuticals and Pfizer for studies to estimate the prevalence of AS. No data from these studies were eligible for this review. All other authors have declared no conflicts of interest. Supplementary data Supplementary data are available at Rheumatology Online.",
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AU - Dean, Linda E.

AU - Jones, Gareth T

AU - MacDonald, Alan G

AU - Downham, Christina

AU - Sturrock, Roger D

AU - Macfarlane, Gary J

N1 - Acknowledgements L.E.D. was supported by a UK Medical Research Council PhD studentship. Disclosure statement: G.T.J., R.D.S. and G.J.M. have received funding from AbbVie Pharmaceuticals and Pfizer for studies to estimate the prevalence of AS. No data from these studies were eligible for this review. All other authors have declared no conflicts of interest. Supplementary data Supplementary data are available at Rheumatology Online.

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N2 - OBJECTIVES: For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.METHODS: A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.RESULTS: The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.CONCLUSION: This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.

AB - OBJECTIVES: For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.METHODS: A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.RESULTS: The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.CONCLUSION: This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.

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KW - Asia

KW - Europe

KW - HLA-B27 Antigen

KW - Humans

KW - Latin America

KW - North America

KW - Prevalence

KW - Spondylitis, Ankylosing

KW - World Health

KW - Spondyloarthropathies

KW - Epidemiology

KW - Systematic Review

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DO - 10.1093/rheumatology/ket387

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JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 4

ER -