Autoimmunity Prevalence Increasing in the United States

Autoimmunity and certain autoimmune diseases have been increasing in prevalence in the United States, according to a new study published in Arthritis & Rheumatology.¹

For the study, researchers investigated the prevalence of antinuclear antibodies (ANA), the most common biomarker for autoimmunity, over a recent 25-year span in the United States. The study examined 3 time periods: 1988 to 1991, 1999 to 2004, and 2011 to 2012.

Standard indirect immunofluorescence assays on HEp-2 cells were used to measure serum ANA in 14,211 study participants 12 years of age and older from the US National Health and Nutrition Examination Survey, looking at approximately one-third from each time period in the study.

Overall, the results showed that the prevalence of ANA was 11% in the first time period, 11.5% in the second time period, and 15.9% in the third time period. This translates to 22, 27, and 41 million individuals affected, respectively, the researchers noted. Compared with the first trend, ANA prevalence increased drastically among adolescents in the second and third time periods, with odds ratios of 2.02 (CI=1.16-3.53) and 2.88 (CI=1.64-5.04), respectively, according to the study.

This increase in prevalence was also observed in both men and women, older adults aged 50 years and older, and in the non-Hispanic white population.

A recent drug trend report from Express Scripts indicated that therapies for inflammatory conditions, such as rheumatoid arthritis, psoriasis, and other autoimmune conditions, accounted for nearly half of spending among different drug classes for commercial drug plans in 2019. With an increasing population facing the high costs of these therapies, medication adherence is especially important, and pharmacists can play an essential role in helping patients manage their treatments.

Related: What Pharmacists Need to Know About Psoriasis Medications

“The reason for the increasing prevalence of ANA, which were most pronounced in adolescents, males and non-Hispanic whites, remain unclear,” senior author Frederick W. Miller, MD, PhD, of the National Institute of Environmental Health Sciences, said in a press release.² “They are concerning, however, as they may herald an increase in autoimmune disorders, and emphasize the need for additional studies to determine the driving forces underlying these findings and to enable the development of possible preventative measures.”

References:

1. Dinse GE, Parks CG, Weinberg CR, et al. Increasing prevalence of antinuclear antibodies in the United States. Arthritis & Rheumatology. 2020. https://doi.org/10.1002/art.41214

2. Is Autoimmunity on the Rise? News Release. Wiley; April 8, 2020. Accessed April 8, 2020. https://newsroom.wiley.com/press-release/arthritis-rheumatology/autoimmunity-rise