TRENDS IN ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODY-ASSOCIATED VASCULITIS-RELATED MORTALITY IN THE UNITED STATES, 1999-2017

Abstract

SESSION TITLE: Monday Electronic Posters 3 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM PURPOSE: Estimates of the national mortality rate related to antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA) are largely unknown. We sought to describe trends in mortality related to ANCA-associated vasculitides from 1999 to 2017. METHODS: Using death certificate data from the Centers for Disease Control and Prevention Wide-ranging OnLine Data for Epidemiologic Research database, we computed standardized mortality rates to the 2000 U.S. population across gender, age, race, and geographic region, and used Joinpoint regression analysis to calculate the average annual percent change in mortality for patients with an ANCA-associated vasculitis. RESULTS: From 1999 to 2017, there were 11,316 ANCA-associated vasculitis-realted deaths in the United States. GPA accounted for 85% of cases. During the study period, the age-adjusted mortality rate was 1.86 (95% CI, 1.83 to 1.90) per 1,000,000 population. Mortality rates had an equal gender distribution and were highest in non-Hispanic whites (2.2 per 1,000,000 population), in the Midwestern United States (2.0 per 1,000,000 population) and increased with age (from 0.54 per 1,000,000 in decedents <65 years-old to 13.0 per 1,000,000 population in decedents aged 75). The age-adjusted mortality decreased from 1999 to 2017 by an average of 1.6% (95% CI, -2.6% to -0.7%) per year. CONCLUSIONS: The national age-adjusted ANCA-associated vasculitides-related mortality rate decreased from 1999 to 2017. Non-Hispanic whites, in particular adults 65 years-old have the highest mortality rates. CLINICAL IMPLICATIONS: Further work needs to be done to determine how steroid-sparing agents, new targeted immunotherapies, and other factors have contributed to the decline in ANCA-associated vasculitis-related mortality in recent years. This information can be used to develop interventions aimed at further decreasing the disease burden. DISCLOSURES: no disclosure on file for Evans Fernández Pérez; No relevant relationships by Alex Steinberg, source=Web Response