ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 30

Complications of Inflammatory Arthritis in First Nations and Non-First Nations Populations of Alberta, Canada

Cheryl Barnabe1, Gilaad Kaplan2, J Antonio Avina-Zubieta3, Diane Lacaille4, Brenda Hemmelgarn5 and JM Esdaile6, 1Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 2Division of Gastroenterology, University of Calgary, Calgary, AB, Canada, 3Arthritis Research Canada / University of British Columbia, Vancouver, BC, Canada, 4Arthritis Research Centre, University of British Columbia, Vancouver, BC, Canada, 5Division of Nephrology, University of Calgary, Calgary, AB, Canada, 6Rheumatology, Arthritis Research Canada, Richmond, BC, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , , ,

Session Information

Date: Sunday, November 8, 2015

Title: Epidemiology and Public Health Poster I: Comorbidities and Outcomes of Systemic Inflammatory Diseases

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:
With markedly improved control of the acute effects of inflammatory arthritis,
the major causes of morbidity and premature death now arise from the
complications of chronic inflammation. Alberta’s First Nations (FN) population has
an increased prevalence of rheumatoid arthritis (RA), ankylosing
spondylitis (AS) and psoriatic disease (PsD includes
psoriasis and psoriatic arthritis) relative to the non-FN population. These
conditions are reported to be more severe in FN which
may result in higher rates of inflammatory complications. Our objective was to
compare incidence rates of recognized complications of inflammation, namely cardiovascular
disease (CVD, including myocardial infarction, stroke, venous thrombotic events),
hospitalized infections, osteoporotic hip fracture, and malignancy (lymphoma,
breast, colon), and conditions newly hypothesized to be secondary to chronic
inflammation (diabetes, chronic obstructive pulmonary disease, COPD) in FN and
non-FN populations. 

Methods:
ICD-9-CA and ICD-10-CM codes from population-based healthcare administrative
data (physician billing claims and hospitalizations, years 1993 to 2011) were
used to define incident cohorts of patients with RA, AS, and PsD using validated definitions. FN identity was determined
from the Alberta Health Care Insurance Plan Registry File. Complications were
determined using validated algorithms of ICD-9-CA and ICD-10-CM codes, with
prevalent cases excluded. Incidence rates of complications were calculated for each
disease cohort overall (per 1,000 person-years), and stratified by FN status to
calculate the incidence rate ratio.

Results:
The disease cohorts include 27,587 persons with RA, 5,120 persons with AS and 4,279
persons with PsD, with FN representing 6.1%, 5.0% and
3.7% of the cohorts respectively. Persons with RA had the highest frequency of CVD,
hospitalized infection, osteoporotic hip fracture, malignancy and COPD compared
to persons with AS and PsD, but persons with PsD had higher incidence rates of diabetes (Table 1). FN
persons with RA, AS and PsD were not at increased
risk for complications of inflammation (Table 2).

Conclusion: There were no significant increases in rates of
complications in FN persons compared to non-FN in our population-based cohort.

Table 1. Incidence Rate (per 1,000 person-years) of Inflammatory Arthritis Complications

Complication

RA (n=27,587)

AS (n=5,120)

PsD (n=4,279)

CVD

14.0

8.3

10.4

Hospitalized Infection

29.7

19.8

22.4

Osteoporotic Hip Fracture

4.7

2.2

3.0

Malignancy

6.5

4.0

5.4

Diabetes

4.8

2.9

5.9

COPD

12.0

6.6

11.2

Table 2. Incidence Rate Ratio (95% confidence interval) for Inflammatory Arthritis Complications in the First Nations relative to non-First Nations Populations

Complication

RA

AS

PsD

CVD

0.7 (0.4 to 1.2)

NR

1.9 (0.5 to 8.1)

Hospitalized Infection

1.3 (0.9 to 1.8)

1.2 (0.4 to 3.8)

0.5 (0.1 to 3.8)

Osteoporotic Hip Fracture

0.8 (0.3 to 2.0)

NR

NR

Malignancy

0.6 (0.3 to 1.4)

NR

NR

Diabetes

2.2 (0.8 to 6.2)

4.6 (0.5 to 40.9)*

NR

COPD

1.1 (0.6 to 1.8)

0.8 (0.1 to 5.8)

1.1 (0.2 to 8.4)*

Results are for fiscal year 2009 unless indicated by * where fiscal year 2008 is reported

NR not reported due to <5 events in the First Nations group during the entire study period

Disclosure: C. Barnabe, None; G. Kaplan, None; J. A. Avina-Zubieta, None; D. Lacaille, None; B. Hemmelgarn, None; J. Esdaile, None.

To cite this abstract in AMA style:

Barnabe C, Kaplan G, Avina-Zubieta JA, Lacaille D, Hemmelgarn B, Esdaile J. Complications of Inflammatory Arthritis in First Nations and Non-First Nations Populations of Alberta, Canada [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/complications-of-inflammatory-arthritis-in-first-nations-and-non-first-nations-populations-of-alberta-canada/. Accessed .

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