Autoimmune disease burden greater than expected

About a tenth of the UK population are suffering from an autoimmune disease, according to a large new study.

Estimates of the rate of autoimmune diseases have been inconsistent, so Dr Nathalie Conrad of the University of Oxford, UK, and colleagues set out to measure rates of 19 common autoimmune diseases.

They used electronic health records from 2000 to 2019, taken from the Clinical Practice Research Datalink, which they describe as representative of the demographics of the UK population.

This covered 22,009,375 individuals. During the study duration, 4.4% were diagnosed with an autoimmune disease, at an average age of 54 years. Women comprised 64% of these cases.

Diagnosis rates increased over time, particularly for coeliac disease, Sjogren’s syndrome, and Graves’ disease. Overall, 10.2% of the population was affected during this time.

Having one autoimmune disease increased the chance of being diagnosed with more.

In The Lancet, the authors write: “Autoimmune diseases affect approximately one in ten individuals, and their burden continues to increase over time at varying rates across individual diseases.

“The inter-relations between autoimmune diseases are commensurate with shared pathogenetic mechanisms or predisposing factors, particularly among connective tissue diseases and among endocrine diseases.”

Dr Conrad said: “Some autoimmune diseases may share common risk factors, such as genetic predispositions or environmental triggers. This was particularly visible among rheumatic diseases and among endocrine diseases.

“But this phenomenon was not generalised across all autoimmune diseases – multiple sclerosis for example, stood out as having low rates of co-occurrence with other autoimmune diseases, suggesting a distinct pathophysiology.”

Senior author, Professor Geraldine Cambridge, added: “There is a crucial need to increase research efforts aimed at understanding the underlying causes of these conditions.”

Conrad, N. et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. The Lancet 5 May 2023; doi: 10.1016/S0140-6736(23)00457-9


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