Hemoglobinopathies in the North of Morocco: Consanguinity Pilot Study

Consanguinity is a social behavior characterized by the arrangement of marriages between relatives. It coincides generally with the geographic distribution of recessive genetic diseases as it increases the likelihood of homozygosis and, consequently, the incidence of their pathologies in the population. In this pilot study, we assess the effect of inbreeding on the burden of hemoglobinopathies in Northern Morocco. From January 2016 to December 2018, 197 children born in the studied region to three ancestral generations and diagnosed with hemoglobinopathies were subject to investigation. The rate of consanguinity in the parents’ generation of children with hemoglobinopathies was 50.25%, with first cousin marriages accounting for 68.69% of consanguineous unions (FI = 0.02). The corresponding rates in the general population, based on a sample of N = 900, were 29.67% and 82.02%, respectively. The marriages between first cousins are the most common among the other types of consanguineous unions. Our study propounds that consanguinity substantially contributes to the hemoglobinopathy burden in the studied region and has changed little over time. Refraining from consanguineous marriages and detecting couples at risk could contribute to the reduction of the incidence of genetic diseases in our country.

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Patterns of Survival Among Patients With Myeloproliferative Neoplasms Diagnosed in Sweden From 1973 to 2008: A Population-Based Study

Journal of Clinical Oncology ◽

10.1200/jco.2012.42.1925 ◽

2012 ◽

Vol 30 (24) ◽

pp. 2995-3001 ◽

Cited By ~ 112

Author(s):

Malin Hultcrantz ◽

Sigurdur Yngvi Kristinsson ◽

Therese M.-L. Andersson ◽

Ola Landgren ◽

Sandra Eloranta ◽

...

Keyword(s):

General Population ◽

Life Expectancy ◽

Excess Mortality ◽

Myeloproliferative Neoplasms ◽

Treatment Options ◽

Large Population ◽

Relative Survival ◽

Population Based ◽

Population Based Study ◽

Over Time

PurposeReported survival in patients with myeloproliferative neoplasms (MPNs) shows great variation. Patients with primary myelofibrosis (PMF) have substantially reduced life expectancy, whereas patients with polycythemia vera (PV) and essential thrombocythemia (ET) have moderately reduced survival in most, but not all, studies. We conducted a large population-based study to establish patterns of survival in more than 9,000 patients with MPNs.Patients and MethodsWe identified 9,384 patients with MPNs (from the Swedish Cancer Register) diagnosed from 1973 to 2008 (divided into four calendar periods) with follow-up to 2009. Relative survival ratios (RSRs) and excess mortality rate ratios were computed as measures of survival.ResultsPatient survival was considerably lower in all MPN subtypes compared with expected survival in the general population, reflected in 10-year RSRs of 0.64 (95% CI, 0.62 to 0.67) in patients with PV, 0.68 (95% CI, 0.64 to 0.71) in those with ET, and 0.21 (95% CI, 0.18 to 0.25) in those with PMF. Excess mortality was observed in patients with any MPN subtype during all four calendar periods (P < .001). Survival improved significantly over time (P < .001); however, the improvement was less pronounced after the year 2000 and was confined to patients with PV and ET.ConclusionWe found patients with any MPN subtype to have significantly reduced life expectancy compared with the general population. The improvement over time is most likely explained by better overall clinical management of patients with MPN. The decreased life expectancy even in the most recent calendar period emphasizes the need for new treatment options for these patients.

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Postbellum America

Americans and Their Weather ◽

10.1093/oso/9780195131826.003.0009 ◽

2000 ◽

Author(s):

William B. Meyer

Keyword(s):

Internal Migration ◽

The Other ◽

National Unity ◽

Climatic Zones ◽

The North ◽

Human Trait ◽

The One ◽

North And South ◽

The U.S ◽

Over Time

One of the earliest historians of the Civil War saw it as a fundamental clash between the peoples of different latitudes. Climate had made the antebellum North and South distinct societies and natural enemies, John W. Draper argued, the one democratic and individualist, the other aristocratic and oligarchical. If such were the case, the future of the reunited states was hardly a bright one. But Draper saw no natural barriers to national unity that wise policy could not surmount. The restlessness and transience of American life that many deplored instead merited, in his view, every assistance possible. In particular, he wrote, Americans needed to be encouraged to move as freely across climatic zones as they already did within them. The tendency of North and South to congeal into hostile types of civilization could be frustrated, but only by an incessant mingling of people. Sectional discord was inevitable only if the natural law that "emigrants move on parallels of latitude" were left free to take its course. These patterns of emigration were left free, for the most part, but without the renewed strife that Draper feared. After the war as before it, few settlers relocating to new homes moved far to the north or south of their points of origin. As late as 1895, Henry Gannett, chief geographer to the U.S. Census, could still describe internal migration as "mainly conducted westward along parallels of latitude." More often as time went on, it was supposed that race and not merely habit underlay the pattern, that climatic preferences were innate, different stocks of people staying in the latitudes of their forbears by the compulsion of biology. Thus, it was supposed, Anglo-Saxons preferred cooler lands than Americans of Mediterranean ancestry, while those of African descent preferred warmer climates than either. Over time, though, latitude loosened its grip and exceptions to the rule multiplied. As the share of the population in farming declined, so did the strongest reason for migrants to stay within familiar climates. Even by the time Gannett wrote, the tendency that he described, though still apparent, was weaker than it had been at mid-century. It weakened because a preference for familiar climates was not a fixed human trait but one shaped by experience and wants, and capable of changing as these variables changed.

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Patterns of Survival and Causes of Death In 9,384 Patients with Myeloproliferative Neoplasms Diagnosed In Sweden Between 1973 and 2008

Blood ◽

10.1182/blood.v116.21.3071.3071 ◽

2010 ◽

Vol 116 (21) ◽

pp. 3071-3071

Author(s):

Malin Hultcrantz ◽

Sigurdur Y. Kristinsson ◽

Therese M-L Andersson ◽

Sandra Eloranta ◽

Åsa Rangert Derolf ◽

...

Keyword(s):

General Population ◽

Cardiac Disease ◽

Causes Of Death ◽

Myeloproliferative Neoplasms ◽

Relative Survival ◽

Relative Number ◽

Population Based ◽

Calendar Period ◽

Population Based Study ◽

Over Time

Abstract Abstract 3071 Background: Available data on survival patterns among patients diagnosed with myeloproliferative neoplasms (MPN) show a great diversity. For instance, in essential thrombocythemia (ET) there are reports stating that survival is not affected by the disease while other investigators consider ET to be a serious disease that significantly reduces life expectancy. Patients with primary myelofibrosis (PMF) are consistently reported to have a shortened life span while polycythemia vera (PV) is associated with a reduced survival in many, but not all, studies. We conducted a comprehensive, population-based study to assess survival and to define causes of death MPN patients, and to compare patterns to the general population. Patients and Methods: The nationwide Swedish Cancer Registry was used to identify all cases of MPN between 1973 and 2008 with follow-up to 2009. Relative survival ratios (RSRs) and excess mortality rate ratios (EMRRs) were computed as measures of survival. The Cause of Death Registry was used to obtain information on causes of death both in the patient and the general population. Results: A total of 9,384 MPN patients were identified (PV n=4,389, ET n=2,559, PMF n=1,048 and MPN not otherwise specified (MPN NOS) n=1,288); 47% were males and the median age at diagnosis was 71. The reporting rate to the Cancer Registry increased over time being well above 95% during the most recent calendar period. There was a significant overall excess mortality in all subtypes of MPN, reflected in 5-year and 10-year RSRs of 0.83 (95% CI 0.81–0.84) and 0.64 (0.62-0.67) for PV, 0.80 (0.78-0.82) and 0.68 (0.64-0.71) for ET and 0.39 (0.35-0.43) and 0.21 (0.18-0.25) for PMF, respectively. Higher age at MPN diagnosis was associated with a poorer survival. For example, the 10-year RSR for patients <50 years was 0.86 (0.83-0.88) as compared to 0.35 (0.29-0.43; p<0.001) in those >80 years. Females had a superior survival, EMRR 0.72 (0.66-0.78), compared to males (reference 1.00). Survival of patients with MPN improved significantly over time with an EMRR of 0.60 (0.53-0.67) in 1983–1992, 0.29 (0.25-0.34) in 1993–2000 and 0.23 (0.19-0.27) 2001–2008 using the calendar period 1973–1982 as a reference (1.00). However, MPN patients of all subtypes including PV and ET had an inferior survival compared to the general population during all calendar periods indicating that these patients continue to experience higher mortality. The 10-year RSRs for patients diagnosed 1993–2008 were 0.72 (0.67-0.76) for PV and 0.83 (0.79-0.88) for ET (Figure). The most common causes of death in MPN patients were, in order, hematological malignancy 27.2%, cardiac disease 27.1%, solid tumors 12.4% and vascular events including thromboembolism and bleeding, 9.2%. Four per cent of patients in this cohort were reported to have died due to acute myeloid leukemia. Over time, the proportion of deaths due to cardiac disease and thromboembolic events has decreased. On the other hand, we observed an increasing relative number of deaths due to hematological malignancies during the more recent calendar periods. The relative risks of dying from these causes in relation to the general population will be presented. Summary/conclusion: In this large population based study including over 9,000 MPN patients, we found all MPN subtypes to have a significantly lower life expectancy compared to the general population. Survival improved over time, however patients of all subtypes including ET had an inferior relative survival even in the most recent calendar period. Especially during earlier years, a certain misclassification and under reporting of ET may have contributed to a reduction in survival rates in the ET group. The relative number of deaths due to cardiac disease and thromboembolic events decreased during more recent calendar periods. This, and the improvement in survival might reflect the introduction of better treatment strategies for both the disease itself and for the prevention and treatment of thromboembolic complications of MPNs. Disclosures: No relevant conflicts of interest to declare.

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The Risk of Second Primary Colorectal Adenocarcinomas Is Not Increased among Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Nationwide Population-Based Study

Neuroendocrinology ◽

10.1159/000492786 ◽

2018 ◽

Vol 107 (3) ◽

pp. 280-283 ◽

Cited By ~ 1

Author(s):

Tobias Stemann Lau ◽

Gitte Dam ◽

Peter Jepsen ◽

Henning Grønbæk ◽

Klaus Krogh ◽

...

Keyword(s):

At Risk ◽

General Population ◽

Population Based ◽

Negative Association ◽

Neuroendocrine Neoplasms ◽

Second Primary ◽

Population Based Study ◽

Gastroenteropancreatic Neuroendocrine Neoplasms ◽

Colorectal Adenocarcinomas

Background: Second primary colorectal adenocarcinomas (SPCA) may occur with a higher frequency in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). In a nationwide population-based study, we investigated the risk of SPCA in GEP-NEN patients and compared it to the general population. Methods: Using the nationwide Danish registries, we identified 2,831 GEP-NEN patients (median age 63 years [IQR 50–73 years], 53% women) diagnosed in 1995–2010. We used Cox regression to compare the incidence of SPCA in GEP-NEN patients relative to a gender- and age-matched general population sample of 56,044 persons. Results: We observed 20 SPCAs among the 2,831 GEP-NEN patients with a total time at risk of 14,003 years (incidence = 143 per 100,000 person-years) and 770 colorectal adenocarcinomas in the general population of 56,044 persons with a total time at risk of 466,801 years (incidence = 165 per 100,000 person-years). The hazard ratio (HR) of SPCA from GEP-NEN diagnosis to the end of follow-up was 1.22 (95% CI: 0.78–1.92) in GEP-NEN patients compared to the general population. This nonsignificant association was the result of a strong positive association in the first 6 months after diagnosis of GEP-NEN (HR = 9.43 [95% CI: 4.98–17.86]) followed by a negative association in the remainder of the follow-up period (HR = 0.50 [95% CI: 0.20–1.21]). Conclusion: In this population-based study, there was no increased risk of SPCA among GEP-NEN patients. The clinical workup in newly diagnosed GEP-NEN patients likely explains the positive short-term association followed by a negative association.

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SAT0252 INCREASED MORTALITY FOR INDIVIDUALS WITH GIANT CELL ARTERITIS: A POPULATION-BASED STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1879 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1069.1-1069

Author(s):

L. Barra ◽

J. Pope ◽

P. Pequeno ◽

J. Gatley ◽

J. Widdifield

Keyword(s):

General Population ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Age Groups ◽

Mortality Rates ◽

Population Based ◽

Population Based Study ◽

Risk Of Mortality ◽

Younger Age ◽

Over Time

Background:Individuals with giant cell arteritis (GCA) are at increased risk of serious morbidity including cardiovascular disease and stroke. Yet the risk of mortality among individuals with GCA have produced conflicting reports1.Objectives:Our aim was to evaluate excess all-cause mortality among individuals with GCA relative to the general population over time.Methods:We performed a population-based study in Ontario, Canada, using health administrative data among all individuals 50 years and older. Individuals with GCA were identified using a validated case definition (81% PPV, 100% specificity). All Ontario residents aged 50 and above who do not have GCA served as the General Population comparators. Deaths occurring in each cohort each year were ascertained from vital statistics. Annual crude and age/sex standardized all-cause mortality rates were determined for individuals with and without GCA between 2000 and 2018. Standardized mortality ratios (SMRs) were calculated to measure relative excess mortality over time. Differences in mortality between sexes and ages were also evaluated.Results:Population denominators among individuals 50 years and older with GCA and the General Population increased over time with 12,792 GCA patients and 5,456,966 comparators by 2018. Annual standardized mortality rates among the comparators steadily declined over time and were significantly lower than GCA morality rates (Figure). Annual GCA mortality rates fluctuated between 42-61 deaths per 1000 population (with overlapping confidence intervals) during the same time period. SMRs for GCA ranged from 1.28 (95% CI 1.08,1.47) at the lowest in 2002 to 1.96 (95% CI 1.84, 2.07) at the highest in 2018. GCA mortality rates and SMRs were highest among males and younger age groups.Conclusion:Over a 19-year period, mortality has remained increased among GCA patients relative to the general population. GCA mortality rates were higher among males and more premature deaths were occurring at younger age groups. In our study, improvements to the relative excess mortality for GCA patients over time (mortality gap) did not occur. Understanding cause-specific mortality and other factors are necessary to inform contributors to premature mortality among GCA patients.References:[1]Hill CL, et al. Risk of mortality in patients with giant cell arteritis: a systematic review and meta-analysis. Semin Arthritis Rheum. 2017;46(4):513-9.Figure.Acknowledgments: :This study was supported by a CIORA grantDisclosure of Interests:Lillian Barra: None declared, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly & Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly & Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB, Priscila Pequeno: None declared, Jodi Gatley: None declared, Jessica Widdifield: None declared

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S134. INCIDENCE, IMPACT AND TRAJECTORIES OF PSYCHOTIC EXPERIENCES FROM CHILDHOOD TO ADULTHOOD, AND PREDICTION OF PSYCHOTIC DISORDER

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.200 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S86-S86

Author(s):

Stanley Zammit ◽

Jon Heron ◽

Alexandros Rammos ◽

Hannah Jones ◽

Daphne Kounali ◽

...

Keyword(s):

At Risk ◽

General Population ◽

Incidence Rate ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Early Adulthood ◽

Self Report ◽

Psychotic Experiences ◽

Longitudinal Profiles ◽

Over Time

Abstract Background Given the global burden of disease of psychotic disorders and the promise of benefit from early intervention, there is an imperative to understand the developmental trajectories from onset of psychotic experiences to clinical disorder and to improve identification of individuals at greatest risk. The aims of this study therefore were: 1) to describe, for the first time, the change in incidence of psychotic experiences in the general population from childhood through early adulthood; 2) to describe the prevalence and burden of unmet clinical need of at-risk mental states and psychotic disorder among young adults in the general population; 3) to examine the predictive ability of both self-reported and interviewer-rated measures of psychotic experiences during childhood and adolescence in identifying psychotic disorder by early adulthood; and 4) to describe longitudinal profiles of psychotic experiences from childhood through early adulthood and investigate a comprehensive range of childhood determinants of symptom persistence. Methods We used data from the ALSPAC birth cohort study. Psychotic experiences and disorder were assessed using semi-structured interviews at ages 12, 18, and 24 (N=7,900 with any data). Incidence rates were estimated using flexible parametric modeling, and positive predictive values (PPVs), sensitivity, specificity, and area under the curve were estimated for prediction. Longitudinal profiles were constructed based on interviewer ratings and frequency of experiences, with profiles describing no experiences (62.5%), episodic experiences (26.5%), persistent/recurrent low frequency (9.1%), and persistent/recurrent high frequency (1.9%) groups. Multinomial regression was used to examine risk factors for persistence, covering socio-demographic, genetic, behavioural, cognitive, and psychological characteristics during childhood. Results The incidence rate of psychotic experiences increased between ages 12 and 24, peaking during late adolescence. A total of 109 individuals (2.8%) met criteria for a psychotic disorder up to age 24, of whom 70% had sought professional help. Prediction of current psychotic disorder at age 24 (N=47, 1.2%), by both self-report and interviewer-rated measures of psychotic experiences at age 18 (PPVs, 2.9% and 10.0%, respectively), was improved by incorporating information on frequency and distress (PPVs, 13.3% and 20.0%, respectively), although sensitivities were low. The PPV of an at-risk mental state at age 18 predicting incident disorder at ages 18–24 was 21.1% (95%CI 6.1, 45.6), and the sensitivity was 14.3% (95%CI 4.0, 32.7). Longitudinal profile analysis showed that persistence was highest in those with higher levels of emotional instability and borderline personality traits in childhood, whilst persistence was strongly related to concurrent and increasing levels of social isolation, anxiety, self-harm, and substance use over time. Discussion Our study results show a peak in incidence of psychotic experience during late adolescence just prior to the peak incidence rate for schizophrenia, and an unmet need for care in young people with psychotic disorders. Although we show the potential efficiency of self-report measures for prediction, because of the low sensitivity, targeting individuals in non-help-seeking samples based only on more severe symptom cutoff thresholds will likely have little impact on population levels of first-episode psychosis. The primary characteristics indexing whether psychotic experiences are likely to persist over time is the presence of emotion regulation difficulties in childhood, providing evidence of a potentially modifiable target for prevention.

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Ten-year risk of cerebrovascular accidents in incident rheumatoid arthritis: a population-based study of trends over time

Rheumatology ◽

10.1093/rheumatology/keaa579 ◽

2020 ◽

Author(s):

Kiana Yazdani ◽

Hui Xie ◽

J Antonio Avina-Zubieta ◽

Yufei Zheng ◽

Michal Abrahamowicz ◽

...

Keyword(s):

General Population ◽

Cox Model ◽

Population Based ◽

Case Definition ◽

P Value ◽

Linear Quadratic ◽

Cox Models ◽

Cerebrovascular Accidents ◽

Interaction Term ◽

Over Time

Abstract Objective To evaluate secular trends in 10-year risk of incident cerebrovascular accidents (CVA), in incident RA relative to the general population. Methods We conducted a retrospective study of a population-based incident cohort with RA onset from 1997 to 2004 in British Columbia, Canada, with matched general population controls (2:1), using administrative health data. RA and general population cohorts were divided according to year of RA onset, defined according to the first RA visit of the case definition. Incident CVA was defined as the first CVA occurring within 10 years from the first RA visit. Secular trend was assessed using delayed-entry Cox models with a two-way interaction term between the year of RA onset and indicator of RA vs general population. Linear, quadratic and spline functions of year of RA onset were compared with assess non-linear effects. The model with the lowest Akaike Information Criterion was selected. Results Overall, 23 545 RA and 47 090 general population experienced 658 and 1220 incident CVAs, respectively. A spline Cox model with a knot at year of onset 1999 was selected. A significant decline in risk of CVA was observed in individuals with RA onset after 1999 [0.90 (0.86, 0.95); P = 0.0001]. The change in CVA risk over time differed significantly in RA with onset from 1999 onwards compared with the general population (P-value of interaction term = 0.03), but not before 1999 (P = 0.06). Conclusion Our findings suggest that people with RA onset from 1999 onwards, had a significantly greater decline in 10-year risk of CVA compared with the general population.

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Abstract T MP46: Stroke Occurrence in Hereditary Hemorrhagic Telangiectasia

Stroke ◽

10.1161/str.46.suppl_1.tmp46 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Kristopher D Masilamani ◽

Jennifer LaBranche ◽

Shaun Malo ◽

Larry Svenson ◽

Thomas Jeerakathil ◽

...

Keyword(s):

General Population ◽

Hereditary Hemorrhagic Telangiectasia ◽

Genetic Disorders ◽

Age Groups ◽

Population Based ◽

Occurrence Rate ◽

Middle Aged ◽

Aged Group ◽

The North ◽

Significant Difference

Purpose: Stroke is an important manifestation of Hereditary Hemorrhagic Telangiectasia (HHT). Many individuals may be unaware they have HHT, even after a stroke, due to its rarity. Our goal was to assess the occurrence of stroke among patients with HHT compared to the general population. Methods: Population-based administrative health data on inpatient and ambulatory admissions were extracted for the period 1997 to 2012 in Alberta using ICD-9 and ICD-10 codes. We observed overall occurrence of strokes in the HHT population and subsequently analyzed the data by gender, specific age groups, and stroke subtypes. Then we compared our findings to stroke occurrence among the general population. Results: The age-standardized occurrence rate of stroke in HHT was about 450 [95% CI 276.4, 622.6] per 100,000 PY compared to 260 [95% CI 259.3, 262.1] per 100,000 PY in the general population. Less than 3% of strokes occurred under 30 years old in both groups. Although the majority of strokes occurred after 60 years of age, 23% of strokes in the general population occurred in the middle-aged group (31-60). The prevalence of HHT in Alberta is 1 in 3,800 and three times as many women were diagnosed with HHT than men by 2012. Conclusion: The prevalence of HHT in Alberta was considerably higher than the North American estimate (1 in 5,000). Individuals diagnosed with HHT were 1.73 times more likely to have a stroke than average, a statistically significant difference. Among the general population, a substantial number of strokes occurred in the middle-aged group. There is a higher probability of an underlying genetic component in strokes occurring before 60 years. For patients who have a stroke before 60 without a clear etiology, clinicians should consider evaluation for genetic disorders such as HHT. This is particularly true for males in whom there may be underdiagnosis of HHT.

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P767 Prevalence and incidence rates of inflammatory bowel disease among First Nations: Population-based evidence from Saskatchewan, Canada

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.895 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S608-S609

Author(s):

J N Peña-Sánchez ◽

D Jennings ◽

J A Osei ◽

M Andkhoie ◽

C Brass ◽

...

Keyword(s):

Health Care ◽

Inflammatory Bowel Disease ◽

General Population ◽

First Nations ◽

Negative Binomial ◽

Population Based ◽

Incidence Rates ◽

Annual Prevalence ◽

Inflammatory Bowel ◽

Over Time

Abstract Background Worldwide, the epidemiology of inflammatory bowel disease (IBD) has been widely studied in the general population; however, there is limited-to-no evidence about IBD among Indigenous peoples, specifically among First Nations (FNs). Saskatchewan (SK) is a province in western Canada with a population of 1.1 million, 11% of whom are FNs. We aimed to estimate the prevalence, incidence, and trends of IBD among FNs in SK since 1999. Methods As part of a patient-oriented research project, we conducted a retrospective population-based study between 1999 and 2016 fiscal years using administrative data for the province of SK. A previously validated algorithm that required multiple health care contacts was applied to identify IBD cases (Crohn’s disease [CD] and ulcerative colitis [UC]). The ‘self-declared FN status’ variable in the Person Health Registration System was used to determine FNs meeting the IBD case definition and the population at risk. Generalised linear models (GLMs) with generalised estimated equations and a negative binomial distribution were used to estimate the annual prevalence of IBD, CD, and UC. Incidence rates and their corresponding 95% confidence intervals (95%CI) were estimated using GLMs with a negative binomial distribution. The GLMs were used to test trends overtime. Results The annual prevalence of IBD among FNs in SK increased from 64 (95%CI 62–66) per 100,000 people in 1999 to 142 (95%CI 140–144) per 100,000 population in 2016. Also, the prevalence of CD and UC increased during the study period, with 53/100,000 (95%CI 52–55) for CD and 87/100,000 (95%CI 86–89) for UC in 2016. The average increase in the prevalence of IBD was 4.2% (95%CI 3.2–5.2) per year, with similar trends observed in CD (4.1% [95%CI 3.3–4.9]) and UC (3.4% [95%CI 2.3–4.6]). The incidence rates of IBD among FNs were 11 (95%CI 5–25) per 100,000 people in 1999 and 3 (95%CI 1–11) per 100,000 population in 2016. No statistically significant changes were observed in the incidence rates over time (p = 0.09). Conclusion This study is the first epidemiological work providing detailed evidence of IBD among FNs. We identified that FNs have increasing trends in the prevalence of IBD, which has also been described in the Canadian general population. In contrast to the general population of Canada and other developed countries that have shown decreasing trends, the incidence rates of IBD among FNs appear to be stable over time. Also, among FNs, UC appears to be more prevalent than CD; this pattern has been observed in the general populations of developing countries. These results illuminate the need to advocate for better health care and wellness for FNs living with IBD.

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Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population—closing the mortality gap

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-209562 ◽

2016 ◽

Vol 76 (6) ◽

pp. 1057-1063 ◽

Cited By ~ 50

Author(s):

Diane Lacaille ◽

J Antonio Avina-Zubieta ◽

Eric C Sayre ◽

Michal Abrahamowicz

Keyword(s):

Rheumatoid Arthritis ◽

General Population ◽

Population Based ◽

Vital Statistics ◽

Mortality Trends ◽

Physician Visits ◽

Rate Ratios ◽

Population Controls ◽

Over Time

ObjectiveExcess mortality in rheumatoid arthritis (RA) is expected to have improved over time, due to improved treatment. Our objective was to evaluate secular 5-year mortality trends in RA relative to general population controls in incident RA cohorts diagnosed in 1996–2000 vs 2001–2006.MethodsWe conducted a population-based cohort study, using administrative health data, of all incident RA cases in British Columbia who first met RA criteria between January 1996 and December 2006, with general population controls matched 1:1 on gender, birth and index years. Cohorts were divided into earlier (RA onset 1996–2000) and later (2001–2006) cohorts. Physician visits and vital statistics data were obtained until December 2010. Follow-up was censored at 5 years to ensure equal follow-up in both cohorts. Mortality rates, mortality rate ratios and HRs for mortality (RA vs controls) using proportional hazard models adjusting for age, were calculated. Differences in mortality in RA versus controls between earlier and later incident cohorts were tested via interaction between RA status (case/control) and cohort (earlier/later).Results24 914 RA cases and controls experienced 2747 and 2332 deaths, respectively. Mortality risk in RA versus controls differed across incident cohorts for all-cause, cardiovascular diseases (CVD) and cancer mortality (interactions p<0.01). A significant increase in mortality in RA versus controls was observed in earlier, but not later, cohorts (all-cause mortality adjusted HR (95% CI): 1.40 (1.30 to 1.51) and 0.97 (0.89 to 1.05), respectively).ConclusionsIn our population-based incident RA cohort, mortality compared with the general population improved over time. Increased mortality in the first 5 years was observed in people with RA onset before, but not after, 2000.

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