Doobaree Indraraj Umesh, Conway Katherine, Miah Haroon, Miah Atiqa, Makris Michael, Hill Quentin, Cooper Nicola, Bradbury Charlotte, Newland Adrian, Provan Drew, McDonald Vickie
Certara EVA, London, UK.
West Sussex University Hospital, Worthing, West Sussex, UK.
Eur J Haematol. 2022 Sep;109(3):238-249. doi: 10.1111/ejh.13803. Epub 2022 Jun 26.
Adult primary immune thrombocytopenia (ITP) is a rare bleeding disorder of unknown cause. Recent estimates of its incidence and trend over time were acquired for England.
The primary ITP population (using ICD 10 code D693 and excluding secondary ITP cases; positive predictive value: 82.6%) was sourced from NHS Digital inpatient and outpatient. Incidence rate (IR) for England and by age groups, sex, and regions were calculated and trends were assessed using average annual percent change (AAPC).
A total of 25 805 patients (mean age 59 years; females 57.8%) diagnosed between 2003 and 2014 was identified. IRs increased from 4.2/100 000 to 6.4/100 000 over this period (AAPC:4.3%). For all sex-specific age groups, the IRs significantly increased over time, except 18-29 years males. The greatest increase was among females aged 30-39 (AAPC:8.7%). In contrast, among ≥70 years, ITP was more common in males (highest IR among ≥80 years males: 23.9/100 000). England's average annual IR was 6.1/100 000 for 2010-14. An estimated 2.5/100 000 (based on UKITP Registry data) was estimated to require 1st line treatment whereas 2.4/100 000 would have 1st and 2nd line treatments within 6 months from diagnosis. IRs for London and East Midlands were the highest (6.5/100 000).
This study found a rising incidence of primary ITP, with sharp increases among young women and elderly men. These findings put in context the impact of ITP on patients' lives and the healthcare services in England, especially with 17%-50% who may develop chronic ITP and require long-term care.
成人原发性免疫性血小板减少症（ITP）是一种病因不明的罕见出血性疾病。近期已获取了英格兰地区该病的发病率及随时间变化的趋势。
原发性ITP人群（使用国际疾病分类第十版代码D693且排除继发性ITP病例；阳性预测值：82.6%）来自英国国民医疗服务体系数字化住院和门诊数据。计算了英格兰地区及按年龄组、性别和地区划分的发病率（IR），并使用年均变化百分比（AAPC）评估趋势。
共识别出2003年至2014年间诊断的25805例患者（平均年龄59岁；女性占57.8%）。在此期间，发病率从4.2/10万增至6.4/10万（AAPC：4.3%）。对于所有按性别划分的年龄组，发病率随时间显著增加，但18 - 29岁男性除外。增幅最大的是30 - 39岁女性（AAPC：8.7%）。相比之下，在70岁及以上人群中ITP在男性中更为常见（80岁及以上男性发病率最高：23.9/10万）。2010 - 2014年英格兰的年均发病率为6.1/10万。据估计，每10万人中有2.5人（基于英国ITP登记数据）需要一线治疗，而每10万人中有2.4人在确诊后6个月内需要一线及二线治疗。伦敦和东米德兰兹地区的发病率最高（6.5/10万）。
本研究发现原发性ITP的发病率呈上升趋势，年轻女性和老年男性增幅明显。这些发现说明了ITP对英格兰患者生活及医疗服务产生的影响，尤其是17% - 50%可能发展为慢性ITP并需要长期护理的患者。
