LAUSR

Background The ANCA-associated vasculitides (AAV) have increased in prevalence since the 1980s, with granulomatosis with polyangiitis (GPA) being most prevalent in Caucasian population in circumpolar areas. This was also shown in a study on GPA in northern Norway between 1984 and 1998, which further showed an increasing incidence [1]. Objectives The present study aimed to investigate the subsequent 15-year period in the same region, now including all the AAVs. Methods The study area has 11 hospitals, no private specialist in rheumatology or nephrology, and an adult population of 371 928. We retrospectively searched all hospital databases, using ICD-10 codes potentially compatible with AAV. Patients diagnosed with AAV from 1999 through 2013 according to the European Medicines Agency (EMEA) algorithm, and for GPA also the subgroup fulfilling the American College of Rheumatology (ACR) 1990 criteria, were included. For prevalence data, patients residing in the area, but with AAV diagnosis prior to 1999, were included too. Results Using the EMEA algorithm, 90 incident cases were classified as GPA, 39 as microscopic polyangiitis (MPA) and 14 as eosinophilic granulomatosis with polyangiitis (EGPA). Within the GPA group, 78 patients also met the ACR criteria. The results for incidence and prevalence are given in Table 1: Annual incidence/million Point prevalence at 31. Dec 1999–2003 2004–2008 2009–2013 Total period 2003 2008 2013 ACR GPA 11,4 16,7 12,5 13,6 149 210 235 EMEA GPA 11,4 19,9 15,7 15,8 149 226 261 EMEA MPA 2,7 6,5 11,0 6,8 10,8 31,9 63,3 EMEA EGPA 2,7 2,7 1,6 2,3 13,5 18,6 30,4 EMEA All AAV 16,8 29,0 28,2 24,9 173 276 354 Conclusions The GPA incidence and prevalence in this study are the highest reported. Though the incidence has stabilized, prevalence is still increasing, albeit at a decelerating rate (Graph 1). Moreover, the total AAV prevalence doubled in the last 10 years, exceeding previous estimates. Incidence of MPA and EGPA are both within the range found elsewhere. But the MPA incidence appears to be rising reminiscent of GPA before the turn of the century. References Koldingsnes W, Nossent H. Epidemiology of Wegener's granulomatosis in northern Norway. Arthritis Rheum. 2000;43(11):2481–2487. Disclosure of Interest None declared