Epidemiology of biopsy-confirmed giant cell arteritis in southern Sweden - an update on incidence and first prevalence estimate.

To characterize the epidemiology of temporal artery biopsy-positive (TAB+) giant cell arteritis (GCA), including trends in incidence, seasonal variation, and prevalence in Skåne, the southernmost region of Sweden.All histopathology reports of TABs from 1997 through 2019 were reviewed to identify patients diagnosed with TAB+ GCA. Incidence rates based on the 23-year period and the point-prevalence at 31 December, 2014 were determined. An alternative prevalence calculation included only TAB+ GCA patients living in the study area and receiving immunosuppressant therapy on the point-prevalence date.1360 patients were diagnosed with TAB+ GCA (71% female). The average annual incidence 1997-2019 was 13.3 (95% CI 12.6-14.0) per 100 000 inhabitants aged ≥50 years and was higher in females (17.8; 95% CI 16.7-18.9) than in males (8.2; 95% CI 7.4-9.0). The age- and sex- standardized incidence declined from 17.3 in 1997-8.7 in 2019, with incidence ratio (IR) of 0.98 per year (95% CI 0.98-0.99). A seasonal variation was observed with higher incidence during spring than winter [IR 1.19 (95% CI 1.03-1.39)]. The overall point-prevalence of TAB+ GCA was 127.1 per 100 000 (95% CI 117-137.3) and was 75.5 (95% CI 67.7-83.3) when including only patients receiving immunosuppressants.Over the past two decades, the incidence of biopsy-confirmed GCA has decreased by ∼2% per year. Still, a high prevalence of GCA on current treatment was observed. More cases are diagnosed during spring and summer than in the winter.

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Authors: Pavlos Stamatis, Aleksandra Turkiewicz, Martin Englund, Carl Turesson, Aladdin J Mohammad