EPIDEMIOLOGY OF IMMUNOGLOBULIN A NEPHROPATHY: EVIDENCE FROM A LITERATURE REVIEW

 

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https://storage.unitedwebnetwork.com/files/1099/6001ea36bfab90a44630db476178be14.pdf
EPIDEMIOLOGY OF IMMUNOGLOBULIN A NEPHROPATHY: EVIDENCE FROM A LITERATURE REVIEW

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Aneesh Thomas
George
Aneesh Thomas George aneesh.george@novartis.com Novartis Healthcare Pvt. Ltd. International Value and Access Hyderabad India *
Harshul Natani harshul.natani@novartis.com Novartis Healthcare Pvt. Ltd. International Value and Access Hyderabad India -
Mark Pletscher mark.pletscher@novartis.com Novartis Pharma AG International Value and Access Basel Switzerland -
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Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerulonephritis that can lead to kidney failure. The objective of the literature review was to collate and summarize evidence on the epidemiology of IgAN.

A comprehensive literature search was performed on February 2024 in EMBASE and Medline databases through the EMBASE platform for relevant English-language studies. Studies were selected through a two-step screening process; (i) abstract screening and (ii) full-text screening.

Of the 165 studies included in this review, majority were retrospective studies (84.2%). Almost half of the included studies were conducted at single centres (48%), and more than one-third were from Asia (36%). The incidence of IgAN varied across studies. The median (minimum, maximum) incidence amounted to 11.6 (1.8, 220) per million population per year [pmp/year]. Peak incidence of IgAN was reported among young adults and least in the elderly population. According to a French study, the incidence was 23 pmp/year (ages 10-19 years), 42 pmp/year (ages 20-39 years), 39 pmp/year (ages 40-59 years) and 11 pmp/year (ages 60-79 years). Higher incidence was observed among males versus females across all age-groups (48 versus 14 pmp/year in France and 14.3 versus 6.5 pmp/year in the US). A Japanese urinalysis screening study in the pediatric population from years 2003-2012 showed that IgAN incidence did not follow a particular trend, with the highest incidence of 174 pmp/year in 2011 and the lowest incidence of 27 pmp/year in 2007. Adult studies with longer observation periods, however, reported an increasing incidence rate over time; 3.4-17.9 pmp/year in Ireland (years 1976-2005) and 1-16 pmp/year in the US (years 2000-2011).  A study of post-transplant patients (N=77) showed that recurrence rates of IgAN was 57.1% at a mean follow up of 67.3 months after transplantation. Data on the prevalence of IgAN was limited. The available evidence suggests that the prevalence ranged from 85 pmp in the US (years 2010-2021) to 2,400 pmp in France (years 1976-1990). A US based study showed an increasing trend in prevalence rates from 270 pmp in 2016 to 382.5 pmp in 2020. According to a UK based study, the condition was more prevalent in males (73 pmp) compared to females (32 pmp). Among renal biopsy patients, IgAN was found to be most prevalent in American Indians (33%) and least prevalent in African Americans (3.8%).

The wide variations in the incidence and prevalence of IgAN observed in this review can be attributed to differences in study-periods, geographies, and aetiologies. Nonetheless, the findings from the review highlights the global burden of IgAN which underlines the need for early diagnosis and disease management with novel interventions.

Kewords