Epidemiologic Trends and Socioeconomic Disparities of Ankylosing Spondylitis in South Korea: A Nationwide Population-Based Study, 2010–2021
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Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021. We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion: This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
Abstract
Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021. We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion: This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.
참고문헌 (26)
- Kwon SR, "The epidemiology and treatment of ankylosing spondylitis in Korea", J Rheum Dis, 29, pp.193~199 (2022)
- Lee JS, "Comorbidity, disability, and healthcare expenditure of ankylosing spondylitis in Korea : a population-based study", PLoS One, 13, pp.e0192524~ (2018)
- Boonen A, "The burden of ankylosing spondylitis", J Rheumatol Suppl, 78, pp.4~11 (2006)
- Park JS, "Trends in the prevalence and incidence of ankylosing spondylitis in South Korea, 2010-2015 and estimated differences according to income status", Sci Rep, 8, pp.7694~ (2018)
- Crossfield SSR, "Changes in ankylosing spondylitis incidence, prevalence and time to diagnosis over two decades", RMD Open, 7, pp.e001888~ (2021)
- Nam B, "Gender differences in factors associated with low quality of life and depression in Korean patients with ankylosing spondylitis", Qual Life Res, 30, pp.2299~2310 (2021)
- Kwon OC, "Effects of immune-mediated inflammatory diseases on cardiovascular diseases in patients with type 2 diabetes : a nationwide population-based study", Sci Rep, 12, pp.11548~ (2022)
- Kim JA, "Towards actualizing the value potential of Korea Health Insurance Review and Assessment(HIRA)data as a resource for health research : strengths, limitations, applications, and strategies for optimal use of HIRA data", J Korean Med Sci, 32, pp.718~728 (2017)
- van der Linden S, "Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria", Arthritis Rheum, 27, pp.361~368 (1984)
- Dubreuil M, "Validity of ankylosing spondylitis diagnoses in the health improvement network", Pharmacoepidemiol Drug Saf, 25, pp.399~404 (2016)
- Kim JW, "Risk of cardiovascular disease associated with long-term use of non-steroidal anti-inflammatory drugs in ankylosing spondylitis", Rheumatology (Oxford) (2024)[DOI]
- Burgos-Vargas R, "Textbook of clinical pediatrics", pp.1601~1609 (2012), Springer
- Park JS, "National pharmacological treatment trends for ankylosing spondylitis in South Korea : a national health insurance database study", PLoS One, 15, pp.e0240155~ (2020)
- Stolwijk C, "Global prevalence of spondyloarthritis : a systematic review and meta-regression analysis", Arthritis Care Res(Hoboken), 68, pp.1320~1331 (2016)
- Boel A, "Age at onset in axial spondyloarthritis around the world : data from the Assessment in SpondyloArthritis International Society peripheral involvement in spondyloarthritis study", Rheumatology(Oxford), 61, pp.1468~1475 (2022)
- Song IH, "Diagnosing early ankylosing spondylitis", Curr Rheumatol Rep, 9, pp.367~374 (2007)
- Aggarwal R, "Diagnosis delay in patients with ankylosing spondylitis : factors and outcomes--an Indian perspective", Clin Rheumatol, 28, pp.327~331 (2009)
- Dean LE, "Differences in the prevalence of ankylosing spondylitis in primary and secondary care : only onethird of patients are managed in rheumatology", Rheumatology(Oxford), 55, pp.1820~1825 (2016)
- Stolwijk C, "The epidemiology of extra-articular manifestations in ankylosing spondylitis : a population-based matched cohort study", Ann Rheum Dis, 74, pp.1373~1378 (2015)
- Stolwijk C, "Prevalence of extra-articular manifestations in patients with ankylosing spondylitis : a systematic review and meta-analysis", Ann Rheum Dis, 74, pp.65~73 (2015)
- Schur L, "Disability at work : a look back and forward", J Occup Rehabil, 27, pp.482~497 (2017)
- Strand V, "Patient burden of axial spondyloarthritis", J Clin Rheumatol, 23, pp.383~391 (2017)
- Koo BS, "Tumour necrosis factor inhibitors slow radiographic progression in patients with ankylosing spondylitis : 18-year real-world evidence", Ann Rheum Dis, 79, pp.1327~1332 (2020)
- van Tubergen A, "The changing clinical picture and epidemiology of spondyloarthritis", Nat Rev Rheumatol, 11, pp.110~118 (2015)
- Ramiro S, "ASAS-EULAR recommendations for the management of axial spondyloarthritis : 2022 update", Ann Rheum Dis, 82, pp.19~34 (2023)
- Rudwaleit M, "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis(part II) : validation and final selection", Ann Rheum Dis, 68, pp.777~783 (2009)
