{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T22:18:56Z","timestamp":1787177936936,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T00:00:00Z","timestamp":1622937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate 22\u2010year trends in the prevalence and incidence of scleritis, and the associations of scleritis with infectious and immune\u2010mediated inflammatory diseases (I\u2010IMIDs) in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The retrospective cross\u2010sectional and population cohort study (1997\u20132018) included 10,939,823 patients (2,946 incident scleritis cases) in The Health Improvement Network, a nationally representative primary care records database. The case\u2013control and matched cohort study (1995\u20132019) included 3,005 incident scleritis cases and 12,020 control patients matched by age, sex, region, and Townsend deprivation index. Data were analyzed using multivariable Poisson regression, multivariable logistic regression, and Cox proportional hazards multivariable models adjusted for age, sex, Townsend deprivation index, race\/ethnicity, smoking status, nation within the UK, and body mass index. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Scleritis incidence rates per 100,000 person\u2010years declined from 4.23 (95% CI 2.16\u20136.31) to 2.79 (95% CI 2.19\u20133.39) between 1997 and 2018. The prevalence of scleritis per 100,000 person\u2010years was 93.62 (95% CI 90.17\u201397.07) in 2018 (61,650 UK patients). Among 2,946 patients with incident scleritis, 1,831 (62.2%) were female, the mean \u00b1 SD age was 44.9 \u00b1 17.6 years (range 1\u201393), and 1,257 (88.8%) were White. Higher risk of incident scleritis was associated with female sex (adjusted IRR 1.53 [95% CI 1.43\u20131.66],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), Black race\/ethnicity (adjusted IRR 1.52 [95% CI 1.14\u20132.01],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004 compared to White race\/ethnicity), or South Asian race\/ethnicity (adjusted IRR 1.50 [95% CI 1.19\u20131.90],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001 compared to White race\/ethnicity), and older age (peak adjusted IRR 4.95 [95% CI 3.99\u20136.14],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001 for patients ages 51\u201360 years versus those ages \u226410 years). Compared to controls, scleritis patients had a 2\u2010fold increased risk of a prior I\u2010IMID diagnosis (17 I\u2010IMIDs,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and significantly increased risk of subsequent diagnosis (13 I\u2010IMIDs). The I\u2010IMIDs most strongly associated with scleritis included granulomatosis with polyangiitis, Beh\u00e7et\u2019s disease, and Sj\u00f6gren\u2019s syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>From 1997 through 2018, the UK incidence of scleritis declined from 4.23 to 2.79\/100,000 person\u2010years. Incident scleritis was associated with 19 I\u2010IMIDs, providing data for rational investigation and cross\u2010specialty engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.41709","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T01:15:11Z","timestamp":1615943711000},"page":"1267-1276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population\u2010Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune\u2010Mediated Inflammatory Disease"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3025-4066","authenticated-orcid":false,"given":"Tasanee","family":"Braithwaite","sequence":"first","affiliation":[{"name":"Centre for Rheumatic Diseases and School of Life Course Sciences King\u2019s College London The Medical Eye Unit Guy\u2019s and St Thomas\u2019 Hospital NHS Foundation Trust, London, UK, and the Institute of Applied Health Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0543-3254","authenticated-orcid":false,"given":"Nicola J.","family":"Adderley","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-7363","authenticated-orcid":false,"given":"Anuradhaa","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-2781","authenticated-orcid":false,"given":"James","family":"Galloway","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Diseases School of Immunology and Microbial Sciences  King\u2019s College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2967-4792","authenticated-orcid":false,"given":"John\u00a0H.","family":"Kempen","sequence":"additional","affiliation":[{"name":"Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, and MyungSung Christian Medical Center General Hospital and MyungSung Medical College  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2167-9572","authenticated-orcid":false,"given":"Krishna","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-5496","authenticated-orcid":false,"given":"Andrew P.","family":"Cope","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Diseases, King\u2019s College London  UK, and St Thomas\u2019 Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-3159","authenticated-orcid":false,"given":"Andrew D.","family":"Dick","sequence":"additional","affiliation":[{"name":"Institute of Ophthalmology University College London, London, UK, and University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-1279","authenticated-orcid":false,"given":"Krishnarajah","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham, Birmingham, UK, and Health Data Research UK  London 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00055735-200112000-00013"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.48.1.7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(84)34160-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.3502"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3182a407c3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.05.026"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/09273948.2013.854394"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"e0237995","DOI":"10.1371\/journal.pone.0237995","article-title":"Incidence, prevalence, and risk factors of infectious uveitis and scleritis in the United States: a 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