Prevalence of Rheumatoid Arthritis and Spondyloarthritis in Turkey: A Nationwide Study

Tiraje TUNCER1, Erdal GİLGİL2, Cahit KAÇAR1, Yeşim KURTAİŞ3, Şehim KUTLAY3, Bülent BÜTÜN1, Peyman YALÇIN3, Ülkü AKARIRMAK4, Lale ALTAN5, Füsun ARDIÇ6, Özge ARDIÇOĞLU7, Zuhal ALTAY8, Ferhan CANTÜRK9, Lale CERRAHOĞLU10, Remzi ÇEVİK11, Hüseyin DEMİR12, Berrin DURMAZ13,
Nigar DURSUN14, Tuncay DURUÖZ15, Canan ERDOĞAN16, Deniz EVCİK17, Savaş GÜRSOY18, Sami HİZMETLİ19, Ece KAPTANOĞLU19, Önder KAYHAN15, Mehmet KIRNAP12, Siranuş KOKİNO20, Erkan KOZANOĞLU21, Banu KURAN22, Kemal NAS23, Sema ÖNCEL24, Dilşad SİNDEL25, Sevim ORKUN26, Tunay SARPEL21, Serpil SAVAŞ27, Ömer Faruk ŞENDUR28, Kazım ŞENEL29, Hatice UĞURLU30, Kaan UZUNCA31, İbrahim TEKEOĞLU23, Francis GUILLEMIN32

1Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University, School of Medicine, Antalya, Turkey
2Private Rheumatologist, Antalya, Turkey
3Department of Physical Medicine and Rehabilitation, Ankara University, School of Medicine, Ankara, Turkey
4Department of Physical Medicine and Rehabilitation, Istanbul University, School of Cerrahpaşa Medicine, Istanbul, Turkey
5Department of Physical Medicine and Rehabilitation, Uludağ University, School of Medicine, Bursa, Turkey
6Department of Physical Medicine and Rehabilitation, Pamukkale University, School of Medicine, Denizli, Turkey
7Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Yıldırım Beyazıt University, School of Medicine, Ankara, Turkey
8Department of Physical Medicine and Rehabilitation, İnönü University, School of Medicine, Malatya, Turkey
9Department of Physical Medicine and Rehabilitation, Medilife Health Group, Istanbul, Turkey
10Department of Physical Medicine and Rehabilitation, Celal Bayar University, School of Medicine, Manisa, Turkey
11Department of Physical Medicine and Rehabilitation, Dicle University, School of Medicine, Diyarbakır, Turkey
12Department of Physical Medicine and Rehabilitation, Erciyes University, School of Medicine, Kayseri, Turkey
13Department of Physical Medicine and Rehabilitation, Ege University, School of Medicine, Izmir, Turkey
14Department of Physical Medicine and Rehabilitation, Kocaeli University, School of Medicine, Kocaeli, Turkey
15Department of Physical Medicine and Rehabilitation, Marmara University, School of Medicine, Istanbul, Turkey
16Department of Physical Medicine and Rehabilitation, Mersin University, School of Medicine, Mersin, Turkey
17Department of Physical Medicine and Rehabilitation, Ufuk University, School of Medicine, Ankara, Turkey
18Department of Physical Medicine and Rehabilitation, Gaziantep University, School of Medicine, Gaziantep, Turkey
19Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University, School of Medicine, Sivas, Turkey
20Department of Physical Medicine and Rehabilitation, Trakya University, School of Medicine (Deceased), Edirne, Turkey
21Department of Physical Medicine and Rehabilitation, Çukurova University, School of Medicine, Adana, Turkey
22Department of Physical Medicine and Rehabilitation, Şişli Etfal Hamidiye Education and Research Hospital, Istanbul, Turkey
23Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sakarya University, School of Medicine, Sakarya, Turkey
24Department of Physical Medicine and Rehabilitation, Dokuz Eylül University, School of Medicine, İzmir, Turkey
25Department of Physical Medicine and Rehabilitation, Istanbul University, School of Medicine, Istanbul, Turkey
26Department of Physical Medicine and Rehabilitation, Beyazpınar Physical Therapy and Rehabilitation Center, Ankara, Turkey
27Department of Physical Medicine and Rehabilitation, Süleyman Demirel University, School of Medicine, Isparta, Turkey
28Department of Physical Medicine and Rehabilitation, Adnan Menderes University, School of Medicine, Aydın, Turkey
29Department of Physical Medicine and Rehabilitation, Atatürk University, School of Medicine (Deceased), Erzurum, Turkey
30Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University, School of Medicine, Konya, Turkey
31Department of Physical Medicine and Rehabilitation, Medikent Hospital, Kırklareli, Turkey
32University of Lorraine, Faculté de Médecine, Directeur EA 4360 APEMAC, Nancy, France

Keywords: Epidemiology; prevalence; rheumatoid arthritis; spondyloarthritis

Abstract

Objectives: This study aims to estimate the prevalence of rheumatoid arthritis (RA) and spondyloarthritis (SpA) in Turkey using the same telephone questionnaire developed for screening RA and SpA in France and used in Serbia and Lithuania.
Material and methods: The study was performed in two steps. In step I, the French questionnaire was translated into Turkish and validated through a group of 200 patients (80 males, 120 females; mean age 44.0±13.1 years; range 19 to 75 years) followed up at the rheumatology departments of University Hospitals in Antalya and Ankara. In step II, the validated Turkish questionnaire was administered face-to-face to randomly selected 4,012 subjects (1,670 males, 2,342 females; mean age 41.5±16.8 years; range 16 to 97 years) by trained general practitioners across the country, in 25 prov- inces for case detection. The subjects who were suspected of having RA or SpA in accordance with the questionnaire were invited to the nearest university hospital for rheumatologic examination in order to confirm the diagnosis.
Results: In step II, a total of 25 subjects (2 males, 23 females) were diagnosed as RA. The standardized RA prevalence for the general population of Turkey was calculated as 0.56% (95% confidence interval [CI]; 0.33-0.79), 0.10% (95% CI; -0.05-0.25) for males and 0.89% (95% CI; 0.51-1.27) for females. A total of 18 subjects (3 males, 15 females) were diagnosed as SpA. The standardized SpA prevalence for the general population of Turkey was 0.46% (95% CI; 0.25-0.67), 0.17% (95% CI; -0.03-0.37) for males and 0.65% (95% CI; 0.32-0.98) for females. The prevalence of RA was highest in the Northern region (2.00%) and the prevalence of SpA was highest in the Central region (1.49%).
Conclusion: The prevalences of RA and SpA in Turkey are close to each other and there are significant inter-regional variations in prevalences of both RA and SpA.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This survey was supported with an unconditional Grant to Turkish League Against Rheumatism from Sanofi Health Products Company (former Aventis), Turkey. The secretary expenses was covered by EULAR Standing Committee on Epidemiology and Health Services Research.