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Epidemiology and treatment outcome of ANCA-associated vasculitis in South Korea: a nationwide, population-based cohort study
J.W. Park1, J. Song2, S. Choi3, S.J. Park4, S.M. Park5, E.Y. Lee6
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, and Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, and Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea. smpark.snuh@gmail.com
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, and Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. elee@snu.ac.kr
CER17418
2024 Vol.42, N°4
PI 0879, PF 0886
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PMID: 38525995 [PubMed]
Received: 26/12/2023
Accepted : 11/03/2024
In Press: 25/03/2024
Published: 29/04/2024
Abstract
OBJECTIVES:
To investigate the epidemiological features of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in South Korea.
METHODS:
We identified the index cases of GPA and MPA using the 2010-2018 Korean National Health Insurance Service database and the Rare Intractable Disease registry for the entire Korean population. Each disease’s incidence and prevalence rates and trends over time were analysed. To assess the impact of disease on morbidity and mortality, a comparator group comprising the general population was established using nearest-neighbour matching by age, sex, income, and comorbidity index, at a 5:1 ratio. Morbidity outcomes included the initiation of renal replacement therapy and admission to the intensive care unit.
RESULTS:
We identified 546 and 795 patients with GPA and MPA, respectively. The incidence rates of both diseases increased with age, with peak incidence rates observed among patients aged ≥70 years. The incidence of MPA increased continuously over time, whereas that of GPA showed no significant changes. During the observation period, 132 (28.7%) and 277 (41.1%) patients in the GPA and MPA groups, respectively, died, which were significantly higher than that in the general population (standardised mortality ratio: 3.53 and 5.58, respectively) and comparator group (hazard ratio: 4.02 and 5.64, respectively). Higher mortality and morbidity rates were observed among patients with MPA than among those with GPA.
CONCLUSIONS:
In South Korea, the incidence of MPA has increased over time. Although both GPA and MPA had high rates of mortality and morbidity, MPA has a poorer prognosis than GPA.
