Improved survival in granulomatosis with polyangiitis: A general population-based study.
Zachary S Wallace1, Na Lu2, Sebastian Unizony1
1Rheumatology, Allergy, and Immunology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Seminars in Arthritis and Rheumatism
|September 2, 2015
Summary
Mortality rates for Granulomatosis with polyangiitis (GPA) significantly decreased between 1992-2002 and 2003-2013. This study shows improved survival for GPA patients over two decades.
Area of Science:
- Rheumatology
- Epidemiology
- Public Health
Background:
- Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease associated with increased mortality.
- Recent trends in GPA mortality within the general population are not well-documented.
Purpose of the Study:
- To evaluate recent mortality trends in Granulomatosis with polyangiitis (GPA) patients.
- To assess changes in GPA patient survival over a two-decade period.
Main Methods:
- Utilized UK's The Health Improvement Network (THIN) data from 1992-2013.
- Identified incident GPA cases and matched them with non-GPA controls.
- Employed Cox-proportional hazards and additive hazard models to analyze mortality rates and differences.
Main Results:
- Identified 465 GPA cases; mortality rates in the early cohort (1992-2002) were substantially higher than in the late cohort (2003-2013).
- Observed a significant reduction in mortality rate difference and hazard ratios for death in the later cohort.
- Mortality improvements were more pronounced in GPA patients compared to the general population controls.
Conclusions:
- Survival for Granulomatosis with polyangiitis patients has significantly improved over the last two decades.
- These findings highlight the positive impact of contemporary management strategies on GPA outcomes.
