TY - JOUR
T1 - Systematic review and meta-analysis: the incidence and prevalence of paediatric coeliac disease across Europe
AU - Roberts, Stephen E.
AU - Morrison-Rees, Sian
AU - Thapar, Nikhil
AU - Benninga, Marc A.
AU - Borrelli, Osvaldo
AU - Broekaert, Ilse
AU - Dolinsek, Jernej
AU - Martin-de-Carpi, Javier
AU - Mas, Emmanuel
AU - Miele, Erasmo
AU - Pienar, Corina
AU - Ribes-Koninckx, Carmen
AU - Thomassen, Rut A.
AU - Thomson, Mike
AU - Tzivinikos, Christos
AU - Thorne, Kymberley
AU - John, Ann
AU - Williams, John G.
N1 - Funding Information: This study was funded by The European Society for Paediatric Gastroenterology Hepatology and Nutrition. The views expressed in this study are those of the authors and not necessarily those of the funding body. Declaration of funding interests: Funding Information: NT has participated as a consultant and/or speaker for Takeda, Nutricia and Danone. EMi has received research support from Nestlé Italiana and Nutricia Italia, honorarium for lectures from Ferring and served as a member of the advisory board from Abbvie. CT has received honorarium for lectures from Abbvie, Sanofi, Nutricia, Nestle and Takeda and travel grants from Nutricia, Merck, Nestle and Olympus. CRK has received honorarium for lectures from Nutricia, Nestle, Casen and Nutriben. All other authors declare no conflicts of interest. Declaration of personal interests: Funding Information: The authors thank Elen Davies for help and advice with systematic review searches and methods, Judy Williams for help with compiling the references and Rosemary Williams, Lynne Tithecott, Caroline Rauter and Jane Pressdee for help and advice with obtaining the manuscripts included in this systematic review. We also acknowledge the Erasmus Research Institute of Management, Rotterdam for meta-analysis guides and software provided. Declaration of personal interests: NT has participated as a consultant and/or speaker for Takeda, Nutricia and Danone. EMi has received research support from Nestl? Italiana and Nutricia Italia, honorarium for lectures from Ferring and served as a member of the advisory board from Abbvie. CT has received honorarium for lectures from Abbvie, Sanofi, Nutricia, Nestle and Takeda and travel grants from Nutricia, Merck, Nestle and Olympus. CRK has received honorarium for lectures from Nutricia, Nestle, Casen and Nutriben. All other authors declare no conflicts of interest. Declaration of funding interests: This study was funded by The European Society for Paediatric Gastroenterology Hepatology and Nutrition. The views expressed in this study are those of the authors and not necessarily those of the funding body. Publisher Copyright: © 2021 John Wiley & Sons Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Coeliac disease is one of the most prevalent immune-mediated gastrointestinal disorders in children. Aim: To review the incidence and prevalence of paediatric coeliac disease, and their trends, regionally across Europe, overall and according to age at diagnosis. Methods: Systematic review and meta-analysis from January 1, 1950 to December 31, 2019, based on PubMed, CINAHL and the Cochrane Library, searches of grey literature and websites and hand searching of reference lists. A total of 127 eligible studies were included. Results: The prevalence of previously undiagnosed coeliac disease from screening surveys (histology based) ranged from 0.10% to 3.03% (median = 0.70%), with a significantly increasing annual trend (P = 0.029). Prevalence since 2000 was significantly higher in northern Europe (1.60%) than in eastern (0.98%), southern (0.69%) and western (0.60%) Europe. Large increases in the incidence of diagnosed coeliac disease across Europe have reached 50 per 100 000 person-years in Scandinavia, Finland and Spain. The median age at diagnosis increased from 1.9 years before 1990 to 7.6 since 2000. Larger increases in incidence were found in older age groups than in infants and ages <5 years. Conclusions: Paediatric coeliac disease incidence and prevalence have risen across Europe and appear highest in Scandinavia, Finland and Spain. The most recent evidence shows large increases in incidence in most regions, but stabilisation in some (notably Sweden and Finland). Sharp increases in the age at diagnosis may reflect increases in milder and asymptomatic cases diagnosed since reliable serology testing became widely used, through endomysial antibodies after 1990 and tissue transglutaminase antibodies around 2000.
AB - Background: Coeliac disease is one of the most prevalent immune-mediated gastrointestinal disorders in children. Aim: To review the incidence and prevalence of paediatric coeliac disease, and their trends, regionally across Europe, overall and according to age at diagnosis. Methods: Systematic review and meta-analysis from January 1, 1950 to December 31, 2019, based on PubMed, CINAHL and the Cochrane Library, searches of grey literature and websites and hand searching of reference lists. A total of 127 eligible studies were included. Results: The prevalence of previously undiagnosed coeliac disease from screening surveys (histology based) ranged from 0.10% to 3.03% (median = 0.70%), with a significantly increasing annual trend (P = 0.029). Prevalence since 2000 was significantly higher in northern Europe (1.60%) than in eastern (0.98%), southern (0.69%) and western (0.60%) Europe. Large increases in the incidence of diagnosed coeliac disease across Europe have reached 50 per 100 000 person-years in Scandinavia, Finland and Spain. The median age at diagnosis increased from 1.9 years before 1990 to 7.6 since 2000. Larger increases in incidence were found in older age groups than in infants and ages <5 years. Conclusions: Paediatric coeliac disease incidence and prevalence have risen across Europe and appear highest in Scandinavia, Finland and Spain. The most recent evidence shows large increases in incidence in most regions, but stabilisation in some (notably Sweden and Finland). Sharp increases in the age at diagnosis may reflect increases in milder and asymptomatic cases diagnosed since reliable serology testing became widely used, through endomysial antibodies after 1990 and tissue transglutaminase antibodies around 2000.
UR - http://www.scopus.com/inward/record.url?scp=85107621313&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/apt.16337
DO - https://doi.org/10.1111/apt.16337
M3 - Review article
C2 - 34115894
SN - 0269-2813
VL - 54
SP - 109
EP - 128
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
IS - 2
ER -