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Yates, Max 
ORCID: https://orcid.org/0000-0003-3977-8920, Graham, Karly, Watts, Richard and Macgregor, Alexander ORCID: https://orcid.org/0000-0003-2163-2325
(2015)
The Prevalence of Giant Cell Arteritis and Polymyalgia Rheumatica in a UK Primary Care Population.
In: UNSPECIFIED.
Abstract
Background: Accurate population prevalence estimates for PMR and GCA are essential for health service planning. However the only data available in the UK are outdated; and estimates for other countries are based on different methods of case ascertainment and classification and vary widely. The aim of this study was provide updated prevalence figures for these conditions in the in the UK based on cases ascertained from primary care and using current definitions. Methods: Clinical data was obtained from practice records of a large general practice in Norfolk, UK. Case records were reviewed for the purposes of diagnosis and classification of GCA and PMR. To ensure that there was not a substantial undiagnosed disease burden within the practice population, the practice population aged 55 years or older was surveyed using a questionnaire designed using published cardinal features of GCA and PMR. Non-responders were sent reminders after 3 months. Questionnaire responses were risk-stratified for potential diagnoses of GCA and PMR and those at high risk reviewed by a rheumatologist. Results: A total of 6159 patients registered with the practice aged 50 years and older. Of these, 22 had a diagnosis of GCA and 117 had a diagnosis of PMR in their care record. A survey was sent to all eligible individuals aged 55 years or older (exclusion criteria included those with terminal illness, dementia or living in a nursing home). 2227 completed questionnaires were returned from the population of 4728 (97.2% with complete data). The median age of the respondents was 68 years (interquartile range 12 years), 52% were female. There were no statistical differences between the median age and gender ratio between responders and non-responders. During the time of the study no participants were identified with a new diagnosis of GCA and no new diagnoses of GCA were made at the practice. 15 participants self-reported a diagnosis of GCA (8 of who were confirmed by the practice) and 83 self-reported a diagnosis of PMR (73 confirmed by the practice). The resulting minimum prevalence estimates for those aged >55 years were 17/10 000 (95% CI 5, 29) for GCA and 154/10 000 (95% CI 119, 190) for PMR. Conclusion: This is the first prevalence estimate of GCA for the UK for 30 years and the first to apply current classification criteria. Community-derived estimates of prevalence are likely to be most representative of true disease burden. Disclosure statement: The authors have declared no conflicts of interest.
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