Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK
Authors' conclusion
Autoimmune diseases affect approximately one in ten individuals, and their burden continues to increase over time at varying rates across individual diseases.
Study context
- Population
- Men and women (no age restriction) registered ≥12 months with a UK general practice in Clinical Practice Research Datalink (CPRD), 2000–2019978,872 newly diagnosed
- Participants
- 22,009,375 men
- Outcome
- Incidence and prevalence of 19 of the most common autoimmune diseases and trends over time
Methodological detailslinked primary and secondary electronic health records (CPRD), age and sex standardised rates, negative binomial regression
- Linked primary and secondary electronic health records (CPRD)
- Age and sex standardised rates
- Negative binomial regression
Main finding
As reported in the abstract
Age and sex standardised incidence of any autoimmune disease and prevalence · 2000–2019
- Incidence of any autoimmune disease, IRR 2017-19 vs 2000-02
- 1.04 [95% CI 1.00-1.09]
- Coeliac disease, IRR 2017-19 vs 2000-02
- 2.19 [2.05-2.35]
- Sjogren's syndrome, IRR 2017-19 vs 2000-02
- 2.09 [1.84-2.37]
- Graves' disease, IRR 2017-19 vs 2000-02
- 2.07 [1.92-2.22]
- Pernicious anaemia, IRR 2017-19 vs 2000-02
- 0.79 [0.72-0.86]
- Hashimoto's thyroiditis, IRR 2017-19 vs 2000-02
- 0.81 [0.75-0.86]
- Population affected by the 19 disorders
- 10.2%
- Women affected
- 1 912 200 [13.1%]
- Men affected
- 668 264 [7.4%]
Observational data: associations, not effects.
Further findings
Socioeconomic gradient (most vs least deprived area)
- Pernicious anaemia IRR
- 1.72 [1.64-1.81]
- RA IRR
- 1.52 [1.45-1.59]
- Graves' disease IRR
- 1.36 [1.30-1.43]
- SLE IRR
- 1.35 [1.25-1.46]
Seasonal variation
- Childhood-onset type 1 diabetes more commonly diagnosed in winter; vitiligo in summer
Co-occurrence with childhood-onset type 1 diabetes vs general population
- Addison's disease IRR
- 26.5 [95% CI 17.3-40.7]
- Coeliac disease IRR
- 28.4 [25.2-32.0]
- Hashimoto's thyroiditis IRR
- 13.3 [11.8-14.9]
- Graves' disease IRR
- 6.7 [5.1-8.5]
- Adjusted for age and sex
Co-occurrence among autoimmune diseases
- Commonly associated, particularly SjD, SLE and SSc; MS particularly low co-occurrence
Original publication
Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet. Published 5 May 2023. doi:10.
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