Pearce Fiona A, Grainge Matthew J, Lanyon Peter C, Watts Richard A, Hubbard Richard B
Division of Epidemiology and Public Health, University of Nottingham.
Department of Rheumatology, Nottingham University Hospitals NHS Trust, Nottingham.
Rheumatology (Oxford). 2017 Apr 1;56(4):589-596. doi: 10.1093/rheumatology/kew413.
To estimate the incidence, prevalence and mortality of granulomatosis with polyangiitis in the UK.
We conducted a historical cohort study using data from the Clinical Practice Research Datalink and Hospital Episode Statistics (HES). We calculated incidence rate ratios, adjusted for age, gender and ethnicity, using Poisson regression.
We identified 462 cases diagnosed between 1997 and 2013. Our overall estimate of incidence was 11.8 (95% CI: 10.7, 12.9)/million person-years. The incidence was 0.88 (95% CI: 0.40, 1.96) in children (aged <16 years) and 14.0 (95% CI: 12.8, 15.4) in adults. The incidence was lower in females (adjusted incidence rate ratio = 0.68; 95% CI: 0.56, 0.81) and highest in the 55-69 year age group (adjusted incidence rate ratio = 6.8, 95% CI: 4.9, 9.6; reference group 16-39 years). The incidence was not significantly different in the Black/Minority Ethnic population from that in the White population (adjusted odds ratio = 0.78, 95% CI: 0.53, 1.13, P = 0.13). The prevalence in 2013 was 134.9 (95% CI: 121.3, 149.6)/million. Mortality was 13.6% at 1-year, and higher in the HES- than in the Clinical Practice Research Datalink-identified cases (hazard ratio = 3.16, 95% CI: 2.19, 4.56, P < 0.001).
By combining primary and secondary care datasets, we have found the incidence and mortality of granulomatosis with polyangiitis to be higher than previously reported. We predict that at present each year in the UK there will be ∼700 new cases, of whom 95 will die within 12 months.
评估英国显微镜下多血管炎的发病率、患病率及死亡率。
我们利用临床实践研究数据链（Clinical Practice Research Datalink）和医院事件统计（Hospital Episode Statistics, HES）的数据进行了一项历史性队列研究。我们使用泊松回归计算了经年龄、性别和种族调整后的发病率比值比。
我们确定了1997年至2013年间诊断的462例病例。我们对发病率的总体估计为11.8（95%置信区间：10.7, 12.9）/每百万人口年。儿童（年龄<16岁）的发病率为0.88（95%置信区间：0.40, 1.96），成人的发病率为14.0（95%置信区间：12.8, 15.4）。女性的发病率较低（调整后的发病率比值比 = 0.68；95%置信区间：0.56, 0.81），在55 - 69岁年龄组中发病率最高（调整后的发病率比值比 = 6.8, 95%置信区间：4.9, 9.6；参照组为16 - 39岁）。黑种人/少数族裔人群的发病率与白种人群相比无显著差异（调整后的优势比 = 0.78, 95%置信区间：0.53, 1.13, P = 0.13）。2013年的患病率为134.9（95%置信区间：121.3, 149.6）/百万。1年时的死亡率为13.6%，HES识别出的病例中的死亡率高于临床实践研究数据链识别出的病例（风险比 = 3.16, 95%置信区间：2.19, 4.56, P < 0.001）。
通过整合初级和二级医疗数据集，我们发现显微镜下多血管炎的发病率和死亡率高于先前报道。我们预测目前英国每年将有大约700例新病例，其中95例将在12个月内死亡。
