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Rheumatoid Arthritis and Spondyloarthropathies: Geographical Variations in Prevalence in France

CHRISTIAN H. ROUX, ALAIN SARAUX, ETIENNE Le BIHAN, PATRICE FARDELLONE, PATRICE GUGGENBUHL, BRUNO FAUTREL, CHARLES MASSON, ISABELLE CHARY-VALCKENAERE, ALAIN CANTAGREL, RENÉ JUVIN, RENÉ-MARC FLIPO, LIANNA EULLER-ZIEGLER, JOEL COSTE, and FRANCIS GUILLEMIN

ABSTRACT.

Objective. To determine geographical variation in the prevalence of rheumatoid arthritis (RA) and spondyloarthropathies (SpA) in France.

Methods. The survey sample was drawn from 7 areas of France. Households were randomly selected using the national telephone directory, and an individual within each household was randomly chosen by the next-birthday method. All cases of suspected RA and SpA were confirmed by the patient's rheumatologist or by clinical examination. Standardized estimates of prevalence were compared between regions and groups of regions.

Results. In total 15,219 anonymous telephone numbers were selected. An average response rate of 64% led to a total of 9395 respondents included in the study. The highest regional rates of RA were observed in the south (range 0.59–0.66%), and the lowest in the north (range 0.14–0.24%), with a national rate of 0.31% (95% CI 0.18–0.48%). Regional heterogeneity was observed for SpA, with the highest rates in Bretagne (0.47%) and the Sud-Est (0.53%) and a national rate of 0.30% (95% CI 0.17–0.46%).

Conclusion. This study is the largest of its kind conducted in France. It shows inter-regional variations, mainly in RA, with a higher prevalence in the south of the country. The many potential reasons for the heterogeneity observed, including genetic and environmental factors, warrant further research. (First Release Nov 15 2006; J Rheumatol 2007;34:117–22)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
SPONDYLOARTHROPATHIES

EPIDEMIOLOGY
PREVALENCE
GEOGRAPHICAL VARIATIONS


From the Department of Rheumatology, University Hospital, Nice; Epidemiology Section, Société Française de Rhumatologie; Department of Rheumatology, University Hospital, Brest; Department of Rheumatology, University Hospital, Nancy; Department of Rheumatology, University Hospital, Amiens; Department of Rheumatology, University Hospital, Rennes; Department of Rheumatology, University Hospital, Paris; Department of Rheumatology, University Hospital, Toulouse; Department of Rheumatology, University Hospital, Grenoble; and Department of Rheumatology, University Hospital, Lille, France.

Supported by an unconditional grant from Pharmacia, France, and a grant from the Société Française de Rhumatologie.

C.H. Roux, MD, Chef de Clinique, Department of Rheumatology, University Hospital, Nice, Epidemiology Section, Société Française de Rhumatologie; A. Saraux, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Brest, Epidemiology Section, Société Française de Rhumatologie; E. Le Bihan, PhD, Biostatisticien, Department of Rheumatology, University Hospital, Nancy; P. Fardellone, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Amiens, Epidemiology Section, Société Française de Rhumatologie; P. Guggenbuhl, MD, Praticien hospitalier, Department of Rheumatology, University Hospital, Rennes, Epidemiology Section, Société Française de Rhumatologie; B. Fautrel, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Paris, Epidemiology Section, Société Française de Rhumatologie; C. Masson, MD, Professeur Universitaire Praticien Hospitalier, Epidemiology Section, Société Française de Rhumatologie; I. Chary-Valckenaere, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Nancy; A. Cantagrel, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Toulouse; R. Juvin, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Grenoble; R-M. Flipo, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Lille; L. Euller-Ziegler, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Nice; J. Coste, MD, Professeur Universitaire Praticien Hospitalier, Epidemiology Section, Société Française de Rhumatologie; F. Guillemin, MD, Professeur Universitaire Praticien Hospitalier, Department of Rheumatology, University Hospital, Nancy, Epidemiology Section, Société Française de Rhumatologie.

Address reprint requests to Dr. C. Roux, Service de Rhumatologie, Hospital l'Archet 1, 242 Avenue de Saint Antoine de Ginestiere, 06200 Nice, France. E-mail: roux101fr@yahoo.fr

Accepted for publication July 7, 2006.




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