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Abstract
Introduction Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder characterised by inflammation of the axial manifestations. For the military draftees, there are no epidemiological data on axSpA in nationwide and population-based databases. This retrospective, nationwide and population-based study aimed to assess the national and regional trends in axSpA prevalence among draft-eligible military populations in South Korea between 2014 and 2023.
Methods The study included 3 063 805 males examined by the Regional Military Manpower Administration. The annual nationwide prevalence was presented as the prevalence per 10 000 and a 95% CIs. The severity of axSpA was assessed using radiographic scoring of the sacroiliac joint based on the New York criteria. Regional trends of axSpA were evaluated for Seoul, metropolitan areas and provinces, categorised according to transportation accessibility.
Results The nationwide prevalence of axSpA increased from 10.75 (95% CI 9.68 to 11.81) in 2014 to 21.18 (95% CI 19.37 to 23.00). The prevalence of radiographic axSpA (r-axSpA) followed a similar upward trend, whereas the prevalence of non-radiographic axSpA (nr-axSpA) remained stable. The prevalence of r-axSpA (52.73% in 2015 and 79.52% in 2019) was higher than that of nr-axSpA. Meanwhile, r-axSpA patients with grade 3 sacroiliitis showed the highest prevalence during the recent 3-year follow-up. The mean regional prevalence of nr-axSpA differed significantly among the three regions (p=0.013), whereas there were no differences in the prevalence of r-axSpA (p=0.084).
Conclusions This epidemiological study revealed an increasing trend in the nationwide prevalence of axSpA over the past decade, primarily driven by an increase in moderate-grade r-axSpA. Therefore, early recognition and awareness of axSpA in young males are essential for initiating appropriate treatment options to slow disease progression.
- Rheumatology
- EPIDEMIOLOGY
- Military Personnel
Data availability statement
Data are available on reasonable request. The datasets analysed during the current study are available through an application to the Public Data Portal, South Korea. This protects the confidentiality of the data and ensures that Information Governance is robust.
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Data availability statement
Data are available on reasonable request. The datasets analysed during the current study are available through an application to the Public Data Portal, South Korea. This protects the confidentiality of the data and ensures that Information Governance is robust.
Footnotes
Contributors All authors read and approved the final manuscript. In addition, all authors have been actively involved in the study in different capacities: J-KM drafted the paper with contributions and approval from all authors. HJK was involved in the concept and design of the study. HJK, PWY, JYY, D-HL, EC, SMP, SP and J-KM were involved in the acquisition and analysis of the data. J-KM accepts full responsibility for the work and conduct of the study and controlled the decision to publish.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.