Clin Exp Rheumatol. 2023 Oct 25. doi: 10.55563/clinexprheumatol/b92b8a. Online ahead of print.

Anders Forss ¹, Adonis Sotoodeh ², Ronald F van Vollenhoven ³, Jonas F Ludvigsson ⁴

Author information

¹Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, and Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden. anders.forss@ki.se.

²Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

³Amsterdam Rheumatology Center ARC, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.

⁴Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; and Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA.

Abstract

Objectives: The reported prevalence of coeliac disease (CD) in patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) varies in previous studies. We aimed to examine the prevalence of CD in patients with RA and JIA.

Methods: We searched Medline, Embase, Cochrane and Web of Science Core Collection between 1 January 1990 and 31 October 2022. In our primary analysis, the prevalence of biopsy-confirmed CD in RA and JIA patients was investigated. In secondary analyses, the prevalence of serological markers for CD was examined. Pooled weighted prevalences of CD and serological markers with 95% confidence intervals (95%CI) were calculated and quality of included studies was assessed. Meta-regression analysis was performed on publication year, sample size, CD prevalence in the general population, proportion of females, and quality assessment score.

Results: In this systematic review, 14 publications were deemed relevant for RA and 22 for JIA, with nine and 18 included in the primary analyses of CD prevalence, respectively. Among a total of 754 RA patients and 2077 patients with JIA, the weighted pooled prevalence estimates of biopsy-confirmed CD were 0.4% (95%CI=0.0-1.2) and 1.4% (95%CI=0.7-2.2), respectively. The pooled prevalence estimates of positive CD serology were 0.9% (95%CI=0.3-1.9) in RA and 5.4% (95%CI=2.5-9.2) in JIA.