Incidence of Clinically Diagnosed Psoriatic Arthritis in Sweden

J Rheumatol. 2025 Jan 1;52(1):38-46. doi: 10.3899/jrheum.2024-0376.

Abstract

Objective: Prior incidence estimates of psoriatic arthritis (PsA) vary considerably. We aimed to assess the annual incidence of clinically diagnosed PsA among adults in Sweden in 2014-2016, overall and stratified by age/sex/education/geography, and to investigate potential time trends in incidence in 2006-2018. Use of disease-modifying antirheumatic drugs (DMARDs) during the 2 years after diagnosis was also examined.

Methods: Patients (aged ≥ 18 years) with incident clinically diagnosed PsA in Sweden were identified from the National Patient Register (NPR) and/or the Swedish Rheumatology Quality Register (SRQ). Population statistics, stratification variables, and DMARD information were retrieved from other nationwide registers. Incidence was estimated according to a base case (BC) definition (ie, ≥ 1 main International Classification of Diseases, 10th revision, diagnosis of PsA [L40.5/M07.0-M07.3] from rheumatology/internal medicine in NPR, or a PsA diagnosis in SRQ during the relevant year, and no prior such diagnoses) and 4 different sensitivity analysis case definitions.

Results: The mean annual incidence of clinically diagnosed PsA among adults in Sweden in 2014-2016 was estimated at 21.77 per 100,000 person-years (PYs) at risk, according to the BC definition; 17.41 per 100,000 PYs at risk after accounting for diagnostic misclassification; and 15.78 to 28.83 per 100,000 PYs at risk across all sensitivity analyses. Incidence was slightly higher in female individuals, was lower in those with higher education (aged > 12 years), and peaked during the ages of 50 to 59 years. No apparent increasing or decreasing time trend was observed in 2006-2018. Within 2 years of diagnosis, 71.03% of patients had received DMARD therapy (22.37% biologic or targeted synthetic DMARDs).

Conclusion: From 2014 to 2016, the annual incidence of clinically diagnosed PsA in the adult Swedish population was approximately 20 per 100,000 PYs at risk. Two years after diagnosis, almost three-quarters of patients had received DMARD therapy.

Keywords: International Classification of Disease; Sweden; epidemiology; incidence; psoriatic arthritis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antirheumatic Agents* / therapeutic use
  • Arthritis, Psoriatic* / diagnosis
  • Arthritis, Psoriatic* / drug therapy
  • Arthritis, Psoriatic* / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Registries*
  • Sweden / epidemiology
  • Young Adult

Substances

  • Antirheumatic Agents