Background/Purpose: Epidemiological studies are important contributors for our understanding of psoriatic arthritis (PsA). Currently, there are no data about temporal trends of prevalence of PsA on the population level. The aim of this study is to estimate the annual age- and sex-specific prevalence of diagnosed PsA in Germany during 2009 to 2012.

Methods: Complete diagnosis data from about 80% of the overall German population from 2009 to 2012 were screened for physician diagnosed and ascertained PsA. Diagnoses are based on claims data from all insurances of the German statutory health insurance (SHI) system. Quality checked claims data were provided by a governmental data trustee. After determining the age- and sex-specific prevalence of PsA for each of the years from 2009 to 2012, trend tests for age-standardized and age-specific prevalence in men and women were applied.

Results: In 2009, a total of 127 thousand patients with diagnosed and ascertained PsA were identified in 64.6 million people from the German SHI. In the following years 2010 to 2012, 138, 146, and 156 thousand people with diagnosed PsA have been observed, respectively. The age-standardized prevalence increases from 1.8 to 2.1 per mil in men (p-trend = 0.009), and from 2.1 to 2.5 per mil in women (p-trend = 0.01). The age-specific prevalence of PsA for men and women increases linearly from age group <20 to a peak of about 60 years of age. After age 60, the age-specific prevalence is steeply decreasing. In virtually all age groups, there is evidence for an increase of the age-specific prevalence with time in men and women. The highest increases are in the age groups 60+.

Conclusion: These data from about 65 million people insured in the German SHI for the first time indicate that there is an increasing prevalence of PsA on the population level. A selection bias is likely to be present, because the roughly 20% of the overall German population not included in our analysis is known to have other health risks (mainly privately insured people). However, our results refer to the vast majority of the German population and the 127 to 156 thousand people with diagnosed PsA. The analysis cannot be adjusted for potential confounders other than age and sex (e.g., socio-economic position or presence of co-morbidities).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increase-in-prevalence-of-psoriasis-arthritis-over-time-analysis-of-claims-data-from-65-million-people-in-germany-from-2009-to-2012/