Time trends in epidemiology and characteristics of psoriatic arthritis over 3 decades: a population-based study.
OBJECTIVE
To determine time trends in incidence, prevalence, and clinical characteristics of psoriatic arthritis (PsA) over a 30-year period.


METHODS
We identified a population-based incidence cohort of subjects aged 18 years or over who fulfilled ClASsification of Psoriatic ARthritis (CASPAR) criteria for PsA between January 1, 1970, and December 31, 1999, in Olmsted County, Minnesota, USA. PsA incidence date was defined as the diagnosis date of those who fulfilled CASPAR criteria. Age- and sex-specific incidence rates were estimated and age- and sex-adjusted to the 2000 US White population.


RESULTS
The PsA incidence cohort comprised 147 adult subjects with a mean age of 42.7 years, and 61% were men. The overall age- and sex-adjusted annual incidence of PsA per 100,000 was 7.2 [95% confidence interval (CI) 6.0, 8.4] with a higher incidence in men (9.1, 95% CI 7.1, 11.0) than women (5.4, 95% CI 4.0, 6.9). The age- and sex-adjusted incidence of PsA per 100,000 increased from 3.6 (95% CI 2.0, 5.2) between 1970 and 1979 to 9.8 (95% CI 7.7, 11.9) between 1990 and 2000 (p for trend < 0.001). The point prevalence per 100,000 was 158 (95% CI 132, 185) in 2000, with a higher prevalence in men (193, 95% CI 150, 237) than women (127, 95% CI 94, 160). At incidence, most PsA subjects had oligoarticular involvement (49%) with enthesopathy (29%).


CONCLUSIONS
The incidence of PsA has been rising over 30 years in men and women. Reasons for the increase are unknown, but may be related to a true change in incidence or greater physician awareness of the diagnosis.
Wilson
Floranne C
FC
Division of Rheumatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. wilson.floranne@mayo.edu
Icen
Murat
M
Crowson
Cynthia S
CS
McEvoy
Marian T
MT
Gabriel
Sherine E
SE
Kremers
Hilal Maradit
HM
D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D001175:Arthrography; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007596:Joints / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D015995:Prevalence; D015203:Reproducibility of Results; D017678:Sex Distribution; D013997:Time Factors; D044465:White People