Prevalence and incidence of celiac disease in patients with rheumatoid arthritis: a case-control study based on the RECORD cohort

Background: The reported prevalence of coeliac disease (CD) in rheumatoid arthritis (RA) is variable. Objective: To evaluate the prevalence and incidence of CD in RA and controls. Design: Case-control study on administrative data. Methods: The RECord linkage On Rheumatic Disease database (administrative data, 2004–2013) was used to retrieve patients with RA and age and sex-matched controls. Prevalence and incidence of CD were calculated and stratified according to age, gender, and calendar year. Results: The cohort included 346,956 subjects (mean age 59.9 (14.5), 70.7% females), of which 70,061 RA and 276,895 controls. Median follow-up was 9 years (IQR 9–9). The prevalence of CD was higher in RA (171/70,061 = 0.24% (0.2–0.3%) vs 398/276895 = 0.14% (0.1–0.2%), p < 0.001). The prevalence of CD among females with RA was increased compared to controls (0.3% vs 0.08%, p < 0.001), but was not increased in males with RA. The incidence was higher in RA and remained stable throughout the observation period. Conclusion: The prevalence and incidence of CD were increased in RA, particularly in females.