Psoriatic arthritis in Reykjavik, Iceland: prevalence, demographics, and disease course.
OBJECTIVE
To determine the prevalence, demographics, and course of psoriatic arthritis (PsA) in the Reykjavik area of Iceland.


METHODS
In total 220 patients >/= 18 years of age living in the Reykjavik area of Iceland were located in a community registry of psoriatic patients and in hospital records. Of these, 156 (71%) were interviewed and examined for verification of skin and joint disease according to published criteria.


RESULTS
Prevalence of PsA in the adult population was estimated to be 164 per 100,000 (95% CI 143-187), adjusted to 139 per 100,000 (95% CI 112-169) after exclusion of 25 individuals. The female to male ratio was close to 2:1. The mean age at skin disease onset was 23 years, with significantly earlier onset in women (age 20 yrs in women vs 26 yrs in men; p = 0.01), but there was no significant difference for age at the time of onset of joint disease. Mean duration of PsA was 20 years. Oligoarthritis was the most common (44%), followed by polyarthritis (31%), enthesitis (8%), and inflammatory back pain (7%). According to patients' recall of clinical features at onset, 78 patients (60%) had changed categories of PsA at the time of the study, most frequently from polyarthritis to oligoarthritis (48%), followed by oligoarthritis to polyarthritis (36%). These changes seemed independent of use of disease modifying drugs, which 54% had received.


CONCLUSIONS
PsA in Reykjavik, Iceland, has a prevalence of at least 0.14% and is strikingly more common in women. The majority of patients reported a change in the pattern of affected joints during the course of their disease.
Love
Thorvardur Jon
TJ
Department of Immunology and Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland. bjorngu@landspitali.is
Gudbjornsson
Bjorn
B
Gudjonsson
Johann Eli
JE
Valdimarsson
Helgi
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003710:Demography; D018450:Disease Progression; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged