Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database

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Abstract
The epidemiology of immune thrombocytopenic purpura (ITP) is not well-characterised in the general population. This study described the incidence and survival of ITP using the UK population-based General Practice Research Database (GPRD). ITP patients first diagnosed in 1990–2005 were identified in the GPRD. Overall incidence rates (per 100 000 person-years) and rates by age, sex, and calendar periods were calculated. Survival analysis was conducted using the Kaplan-Meier and proportional hazard methods. A total of 1145 incident ITP patients were identified. The crude incidence was 3·9 (95% confidence interval [CI]: 3·7–4·1). Overall average incidence was statistically significantly higher in women (4·4, 95% CI: 4·1–4·7) compared to men (3·4; 95% CI: 3·1–3·7). Among men, incidence was bimodal with peaks among ages under 18 and between 75–84 years. The hazard ratio for death among ITP patients was 1·6 (95% CI: 1·3–1·9) compared to age- and sex-matched comparisons. During follow-up 139 cases died, of whom 75 had a computerised plausible cause of death. Death was related to bleeding in 13% and infection in 19% of these 75. In conclusion, ITP incidence varies with age and is higher in women than men. This potentially serious medical condition is associated with increased mortality in the UK.