Prevalence of rheumatoid arthritis in Serbia

International audienceThe aim of this study was to estimate the prevalence of rheumatoid arthritis (RA) in Serbia, using the European EULAR project methodology. In a detection phase, a previously translated and validated telephone Questionnaire was used by lay interviewers on 6,213 randomly selected telephone numbers representing urban population from four Serbian towns: Belgrade (north), Cacak, Uzice and Krusevac (south). Patients with suspected RA were called again by a rheumatologist. For patients with self-reported diagnosis and positive symptoms, patient's rheumatologist was contacted to confirm diagnosis; a complete rheumatologist examination was scheduled for those with positive symptoms only. Prevalence estimates were standardised for age and sex in relation to Serbian population (census 2002) and further to French population, according to EULAR project methodology. The response rate was 63.6 % (3,950 respondents). The rheumatologist called 571 people, among whom 23 RA cases were confirmed (21 diagnosed previously and 2 newly diagnosed during the examination). The prevalence was 0.16 % (95 % confidence interval CI 0.01-0.32) for men and 0.51 % (95 % CI 0.26-0.76) for women; a female-to-male ratio 3.18. The overall Serbian standardised prevalence was 0.35 % (95 % CI 0.18-0.52); when standardised on French population 0.34 % (95 % CI 0.17-0.51). The highest age-specific rate was in the 65-74-year age band. The EULAR prevalence study, conducted with similar methodology and design, showed that RA prevalence estimates in Serbia (0.34 %) were in accordance with France (0.31 %), but lower than in Lithuania (0.55 %)

Prevalence of spondyloarthritis and its subtypes - are they really comparable?

Introduction/Objective. Increasing spondyloarthritis (SpA) prevalence in the last several decades cannot be attributed to disease manifestations alone. The objective of this paper is to review the prevalence of SpA and its subtypes: ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), SpA related to inflammatory bowel disease (IBD) and undifferentiated SpA (UnSpA). Methods. MEDLINE literature search was done via PubMed, Google Scholar, and Embase databases, using terms for spondyloarthritis, and prevalence, with an additional hand searching. Results. As compared with southern European countries, northern European countries (Scotland, Sweden, France) showed lower SpA prevalence rates (0.21–0.45% vs. 1.06% and 1.35% in Italy and Turkey, respectively). The lowest world SpA prevalence was in African and Southeast Asian countries (0–0.19%), and the highest was in Alaska (2.5%). The widest variability in PsA prevalence was in Europe (northern 0.02–0.19%, southern 0.42%). The lowest world PsA prevalence was in Japan (0.001%), followed by China (0.01–0.10%). The European ReA prevalence ranged from 0.04% in Greece to 0.10% in Serbia and Germany, and the European UnSpA prevalence varied from 0.02% in Serbia to 0.67% in Germany; the highest world UnSpA prevalence was in Lebanon (3.4%). Studies aimed at estimating the SpA prevalence differed in sampling strategy and confirmation criteria, different cutoffs for age groups inclusion, presentation of standardized or row results, etc. Conclusion. Variation in the SpA prevalence cannot be attributed to genetic or geographic distribution only. Differences in methodology of studies add to the diversification, described more in-depth in this review

25(OH) vitamin D deficiency in lymphoid malignancies, its prevalence and significance. Are we fully aware of it?

Introduction Vitamin D has a role in cellular differentiation, proliferation, apoptosis, and angiogenesis and therefore is studied as a prognostic factor in cancer. The aim of our study was to assess the prevalence and significance of 25(OH)D deficiency in patients with lymphoid malignancies. Methodology Between January 2014 and June 2016 at the Clinic for Hematology, Clinical Center of Serbia, Belgrade, the pretreatment serum level of 25(OH)D was determined in 133 (62 women/71 men, median age 58 (18-84) years) previously untreated patients with lymphoid malignancy using a chemiluminescent immunoassay. From their medical records, we noted the age, clinical stage, Eastern Cooperative Oncology Group Performance Scale (ECOG PS), nutritional status using the Nutritional Risk Score 2002 (NRS2002), the time of year, comorbidity index, progression, and progression-free survival (PFS) for a median of 20 (1-32) months. The optimal cutoff point for prediction of outcome was determined using the Maximally Selected Rank Statistics. Results There were 37 (27.8%) patients with the severe 25(OH)D deficiency lt = 25 nmol/l, 80 (60.2%) with 25(OH)D deficiency 25-50 nmol/l, and 16 (12%) with 25(OH)D insufficiency 50-75 nmol/l. None of the patients had the desired normal level. There were significant differences between groups in regard to ECOG PS, NRS2002, type of lymphoma, and progression. The severely 25(OH)D-deficient patients had a shorter mean time until progression (P = 0.018). Cox regression analysis showed that 25(OH)D lt 19.6 nmol/l remained the only significant parameter for PFS (HR = 2.921; 95% CI 1.307-6.529). Conclusion The prevalence of 25(OH)D deficiency in the analyzed group of patients with lymphoid malignancies is high and greater in malnourished individuals. Patients with pretreatment serum 25(OH)D lt 19.6 nmol/l had a significantly shorter PFS