One in ten affected by autoimmune disease

Autoimmune diseases affect about one in ten people, according to new findings presented at the European Alliance of Associations for Rheumatology (EULAR) yesterday.

Nathalie Conrad, of the Department of Public Health and Primary Care at KU Leuven, Belgium, used data from the electronic health records of 22 million people in the UK to calculate incidence and prevalence of 19 of the most common autoimmune diseases.

The study was carried out to clarify the picture surrounding autoimmune disease, some of which has seen an increase in incidence, raising the possibility environmental factors might be partly to blame.

Between 2000 and 2019, 978,872 people were given a new diagnosis of one or more of the 19 autoimmune diseases and disorders studied, affecting 10.2% of the population (13.1% of women and 7.4% of men).

The team found age-standardised incidence rates of autoimmune diseases increased by 4% over the study period, with similar rates in both men and women. The largest increases – doubling over the past 20 years – were in Graves’ disease, coeliac disease, and Sjogren’s syndrome.

Over the same period, the incidence dropped significantly for Hashimoto’s thyroiditis and pernicious anaemia.

When the team examined trends in the data, they found a socioeconomic gradient across several diseases, including Graves’ disease, pernicious anaemia, rheumatoid arthritis, and systemic lupus erythematosus.

Seasonal variations were observed for type 1 diabetes and vitiligo, which are more commonly diagnosed in winter and summer, respectively. Regional variations were also observed for a range of conditions.

Speaking to delegates at the conference in Milan, Italy, Conrad said: “Autoimmune disorders are commonly associated with each other, particularly Sjogren’s, systemic lupus erythematosus, and systemic sclerosis.

“Patients with type 1 diabetes also have significantly higher rates of Addison’s, coeliac, and thyroid diseases, and multiple sclerosis stands out as having low rates of co-occurrence with other autoimmune diseases.”

She said the results suggest the burden of autoimmune disease continues to increase over time, possibly because awareness for some conditions has increased over the study period, as well as improved coding practices and earlier recognition.

It is also possible that environmental factors could be implicated in disease pathogenesis.

Conrad N, et al. Incidence, prevalence and co-occurrence of autoimmune disorders, trends over time and by age, sex and socioeconomic status. A population-based study in 22 million individuals. Presented at EULAR 2023; Abstract OP0007.

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