Trends in mortality due to GPA/MPA across Europe: insights from a decade of death registrations

To examine contemporary trends in mortality due to granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in Europe.

We utilised publicly available data from Eurostat on deaths recorded with GPA or MPA as the underlying cause of death for the period 2011-2021. Crude and standardised mortality rates (SMRs) were calculated for each country and linear regression used to determine changes in mortality rates over time. Crude mortality rate was also stratified by age and sex. To investigate the association between geography and mortality rate, the SMR for each country was displayed on a choropleth map and plotted against the country's latitude.

Our analysis of 29 European countries showed a stable mortality rate due to GPA and MPA between 2011-2021, but rising age at death (median age-band 70-74 at the start and 75-79 at the end of the study period). There were differences between countries with the highest mortality rate in Denmark (SMR 31.03 per 10 million) and the lowest in Romania (SMR 0.77 per 10 million). Mortality rates were higher in adults aged over 80 years and there were more deaths in men compared with women. A latitudinal gradient in SMR was seen in GPA but not MPA, with the highest mortality rates in Scandinavia.

Despite major advances in disease management, our results show that deaths due to GPA and MPA were stable over the last decade, indicating an ongoing need to improve the treatment of these diseases.