Department of Internal Medicine, Rheumatology and Immunology, Medius Klinik, Academic Teaching Hospital, University of Tübingen, Kirchheim unter Teck.
Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.
Rheumatology (Oxford). 2021 Oct 2;60(10):4868-4873. doi: 10.1093/rheumatology/keaa924.
ANCA-associated vasculitides (AAV) are rare, potentially life-threatening autoimmune diseases characterized by systemic inflammation and organ damage. AAV prevalence rates reported in Europe vary considerably and robust data sources are often lacking. This study aimed to examine the feasibility of claims data analysis as a complementary method to registry-based studies to assess the epidemiology of AAV.
In this retrospective observational study, anonymized longitudinal claims data from years 2013-2016 from German statutory health insurance companies (data source: InGef, Institute for Applied Health Research) have been analysed on an age- and gender-stratified cohort of ∼3 million persons representative of the German population. In this cohort, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients were identified.
The study cohort revealed a prevalence for GPA and MPA of 210 and 46 cases per million people, respectively. The annual incidence comprised 34 GPA cases and 13 MPA cases per million people per year. Hence, 17 500 AAV patients (GPA and MPA) are estimated to live in Germany, with an annual increase of 3200 patients. According to their demographic and disease-specific characteristics, AAV patients identified in this claims data approach are representative.
This is the first study using claims data to assess the epidemiology of AAV. In Germany, AAV was diagnosed more frequently than it was estimated by previous self-reporting registry-based studies. The findings indicate that epidemiological data of AAV may have been underestimated but may also reflect improved diagnostic methods and disease recognition.
抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)是一种罕见的、可能危及生命的自身免疫性疾病,其特征为全身炎症和器官损伤。欧洲报道的 AAV 患病率差异很大,且往往缺乏可靠的数据来源。本研究旨在探讨利用索赔数据分析作为基于登记的研究的补充方法来评估 AAV 流行病学的可行性。
在这项回顾性观察性研究中,对来自德国法定健康保险公司(数据源:InGef,应用健康研究研究所)的 2013 年至 2016 年的匿名纵向索赔数据,在一个年龄和性别分层的、约 300 万人群的队列中进行了分析,该队列代表了德国人口。在该队列中,识别出肉芽肿性多血管炎(GPA)和显微镜下多血管炎(MPA)患者。
研究队列显示 GPA 和 MPA 的患病率分别为每百万人 210 例和 46 例。年发病率包括每百万人每年 34 例 GPA 病例和 13 例 MPA 病例。因此,估计有 17500 例 AAV 患者(GPA 和 MPA)生活在德国,每年增加 3200 例。根据他们的人口统计学和疾病特异性特征,在该索赔数据中识别出的 AAV 患者具有代表性。
这是第一项使用索赔数据评估 AAV 流行病学的研究。在德国,AAV 的诊断频率高于之前基于自我报告的登记研究的估计。研究结果表明,AAV 的流行病学数据可能被低估了,但也可能反映了诊断方法的改进和疾病的识别。