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Observational Study
. 2022 Nov 16;20(1):100.
doi: 10.1186/s12969-022-00755-x.

Incidence, prevalence, and comorbidities of juvenile idiopathic arthritis in Germany: a retrospective observational cohort health claims database study

Gerd Horneff  1   2 , Julia Borchert  3 , Ria Heinrich  3 , Simon Kock  4 , Pascal Klaus  5 , Heike Dally  5 , Christine Hagemann  5 , Joanna Diesing  3 , Tonio Schönfelder  6   7
Affiliations
Observational Study

Incidence, prevalence, and comorbidities of juvenile idiopathic arthritis in Germany: a retrospective observational cohort health claims database study

Gerd Horneff et al. Pediatr Rheumatol Online J. .

Abstract

Background: Juvenile idiopathic arthritis (JIA) describes heterogenous categories of chronic inflammatory rheumatic conditions of unknown origin in children and adolescents. Epidemiological data in the literature vary, depending on geographic location, ethnicity and the case definition used. We evaluated epidemiology, especially that of the categories defined by the International League of Associations for Rheumatology (ILAR).

Methods: Using data from two different longitudinal health claims databases (WIG2 and InGef) from January 1st, 2013 to December 31st, 2019, we looked at patients aged 2 to 15 years old with at least one main inpatient or two secondary inpatient/verified outpatient ICD-10 diagnoses in at least two different quarters within one calendar year. We calculated prevalence and incidence (per 100,000 patients) and extrapolated data to the entire German population, looking at differences in gender and age groups. Additionally, we collected data on "other" not necessary comorbidities in our JIA patient population.

Results: Of the 3-4 million patients in the databases (respectively) in 2018, we found a total of 546 (WIG2) and 849 (InGef) patients that met our JIA case definition, with an incidence of 34 (29-41) and 60 (53-67) and prevalence of 133 (122-145) and 168 (157-179). Both incidence and prevalence throughout the age range were mostly higher in females than males, however the difference between females and males increased with increasing age. Of the ILAR categories, oligoarthritis was the most prevalent (70 and 91 per 100,000), with about half of our JIA patients in this category, followed by undifferentiated arthritis (49 and 56 cases per 100,000) and rheumatoid factor negative (RF-) (31 and 39 per 100,000). Incidence in 2018 was the highest in these three categories. Atopic dermatitis, vasomotor and allergic rhinitis, and uveitis were the pre-defined comorbidities seen most often in both databases.

Conclusion: This study provides current incidence and prevalence JIA data in Germany, contributing to knowledge on burden of disease and tools for healthcare planning.

Keywords: Burden of disease; Comorbidities; Incidence; JIA; Juvenile idiopathic arthritis; Polyarticular JIA; Prevalence.

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Conflict of interest statement

All authors had complete autonomy for the process of designing the study, carrying out the analyses, interpreting the results and writing the manuscript. PK, CH, HD are employees of Pfizer Pharma GmbH. JB, RH, JD and TS are all employees of WIG2 GmbH, which is an independent institute and paid consultant to Pfizer Pharma GmbH for designing the study, carrying out the analyses, interpreting the results and writing the manuscript. GH received an honorarium from Pfizer Pharma GmbH in connection with designing the study and interpreting the results.

Figures

Fig. 1
Fig. 1
Patient selection of each prevalence and incidence population (data shown for 2018 only)
Fig. 2
Fig. 2
Overall JIA prevalence and incidence rates per 100,000 population in Germany (database data extrapolated). Error bars indicate 95% confidence intervals
Fig. 3
Fig. 3
Predefined comorbidities in prevalent JIA and polyJIA patients in 2018 for WIG2 and InGef databases *comorbidities for which the number of cases was < 5 are only reported as such, due to data protection laws. For this reason, a rate could not be generated for these comorbidities
See this image and copyright information in PMC

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