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Epidemiology and comorbidity of juvenile idiopathic arthritis in Poland- a nationwide study
Zbigniew Żuber1, Krzysztof Podwójcic2, Mateusz Szeląg2
1Department of Pediatrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University, Krakow, Poland. zbyszekzuber@interia.pl.
Insights
Juvenile idiopathic arthritis (JIA) incidence and prevalence in Poland are lower than projected, with rates of 4.30 and 78.80 per 100,000 in 2022. This study offers a contemporary JIA burden estimate for the region.
Area of Science:
- Pediatric rheumatology
- Epidemiology
- Public health
Background:
- Advancements in JIA diagnostics and treatment strategies, including disease-modifying drugs (DMARDs), may have influenced JIA's epidemiological landscape.
- Understanding current JIA trends is crucial for public health resource allocation and patient care.
Purpose of the Study:
- To provide a contemporary, nationwide estimate of the burden of juvenile idiopathic arthritis (JIA) in Poland.
- To analyze incidence, prevalence, and associated healthcare costs of JIA in children under 16.
Main Methods:
- Utilized National Health Fund (NHF) healthcare utilization records from 2010-2022.
- Defined JIA cases using ICD-10 codes and DMARD prescriptions (ATC codes) for individuals under 16.
- Analyzed incidence rates (IRs), prevalence, co-occurring conditions, and outpatient healthcare costs.
Main Results:
- In 2022, JIA incidence and prevalence were 4.30 and 78.80 per 100,000, respectively. Pediatric JIA IRs ranged from 24.0 to 38.7 per 100,000.
- Females showed greater susceptibility (IR ratio 1.16-1.53). Common co-occurring conditions included allergic rhinitis (17.5%), bronchial asthma (12.3%), and chronic tonsillitis/pharyngitis (12.2%).
- Median annual healthcare cost per JIA patient was 37.8€.
Conclusions:
- This study presents a comprehensive, nationwide JIA burden estimate for Poland.
- JIA occurrence and overall burden align with the lower end of projected figures for the region.
- Findings suggest JIA burden in Poland is lower compared to Scandinavian nations.
Background:
Diagnostic pathways for patients with juvenile idiopathic arthritis (JIA) have gradually improved over time. Provider practice has also shifted towards goal-oriented treatment with disease-modifying drugs (DMARDs) that together may have changed the epidemiologic landscape of JIA.
Methods:
Public healthcare utilization records from the National Health Fund (NHF) were screened between 2010 and 2022. For individuals aged < 16 years, we utilized a narrow JIA case definition combining repeat ICD-10 encoding with DMARDs prescription based on ATC codes.
Results:
In 2022, we identified 1,625 incident and 29,758 prevalent JIA cases (< 16 years), which corresponds to incidence (IRs) and prevalence rates of 4.30 and 78.80 per 100,000 persons of the general population. For the pediatric population, annual IRs for JIA (< 16 years) ranged between 24.0 (95% CI 22.8, 25.2) and 38.7 (95% CI 37.2-40.3) per 100,000. Greater susceptibility among females was also consistently observed with the annual IR ratio ranging between 1.16 and 1.53. The most common concurrent disorders based on medical care services were allergic rhinitis (N = 5,200, 17.5%), bronchial asthma (N = 3,661, 12.3%) and chronic tonsillitis/pharyngitis (N = 3641, 12.2%). Analysis of 214,285 outpatient care visits revealed a median (IQR, range) annual healthcare cost of 37.8€ (35.8-47.4€, 30.3-86.1€) per JIA patient.
Conclusions:
This comprehensive, nationwide study provides a contemporary estimate of JIA burden in Poland. Our findings indicate that both the occurrence of new cases and overall burden of JIA in the past ten years align with the lower end of projected figures for our geographical area, especially when compared with Scandinavian nations.
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