Skip to main content
  • Meeting abstract
  • Open access
  • Published:

Rising prevalence of systemic autoimmune rheumatic disease: increased awareness, increased disease or increased survival?


The reported prevalence of systemic autoimmune rheumatic disease (SARD) varies markedly worldwide depending on case definitions and population studied. Administrative healthcare databases provide comprehensive longitudinal datasets to estimate changing trends, but their accuracy for identifying SARD must be established, given their use for billing purposes and the diagnostic uncertainty inherent in the disease.


In a stable population of over 900,000 adults, we used hospital and physician claims from a large administrative database using two different case definitions for the 5-year period prevalence of SARD from 1995 to 2010. For each 5-year interval, the mid-year population was used as the denominator. For physician claims, we identified SARD using The International Classification of Diseases (ICD)-9 Code 710. For hospital claims we identified SARD using the ICD-9 Code 710 from 1995 to 2004, and the ICD-10 Code M32 from 2004 onwards. Two case definitions were used: ≥5 claims ever for SARD by any physician, or ≥2 SARD claims ≥2 months apart from a specialist within the 5-year period. Prevalence rates by age (18 to 30; 31 to 50; and >50 years) and sex were calculated. The healthcare database was linked with a prescription database, and the proportion of patients treated with glucocorticoids, antimalarials and immunosuppressives was calculated.


The prevalence rate for SARD ranged from 0.08 to 0.013% in 1995 to 2000, and rose to 0.13 to 0.16% in 2005 to 2010, depending on the case definition of SARD. Prevalence rates for females aged >50 rose from 0.25% in 1995 to 2000 to 0.36% in 2005 to 2010, while all other age and sex groups remained stable (Figure 1). The proportion of patients receiving glucocorticoid prescriptions declined slightly from 64% in 1995 to 60% in 2010, while the proportion of antimalarial, moderate and severe immunosuppressive prescriptions increased: 43 to 56%; 24 to 44%; and 3.6 to 6.6% respectively. Rheumatology manpower in the region doubled from 0.47 to 1.2/100,000 from 1995 to 2010.

Figure 1
figure 1

Prevalence of SARD by age and sex.


We found a rise in the prevalence of SARD over the 15-year period. This may reflect improved survival, given the rising rate in females >50, or improved ascertainment due to increasing awareness of SARD among physicians, and increased rheumatology manpower. This study also illustrates changing treatment patterns with less use of glucocorticoids and greater use of antimalarials and immunosuppressives, which may contribute to improved survival. Further attempts at determining diagnostic accuracy and disease outcomes in this population using linkages with clinical databases are underway.

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Peschken, C., Hitchon, C. Rising prevalence of systemic autoimmune rheumatic disease: increased awareness, increased disease or increased survival?. Arthritis Res Ther 14 (Suppl 3), A20 (2012).

Download citation

  • Published:

  • DOI: