A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy

Kwon, Christina Soeun; Daniele, Patrick; Forsythe, Anna; Ngai, Chris

doi:10.36469/jheor.2021.26129

Cited by 34 publications

(34 citation statements)

References 65 publications

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“…The IgAN incidence rates among Japanese, Taiwanese, and Australian populations ranged from 0 to 10.7 per 100,000 people per year, higher than the incidence rate reported in a recent systematic literature review (SLR) by Kwon 2021 [ 84 ] (1.29 per 100,000 people per year). Kwon 2021 [ 84 ] is an SLR focusing on US epidemiology, health-related QoL, and the economic burden of IgAN (the included studies were published from January 2010 to June 2020), similar to our study’s objective. Incidence rates among children and teenagers (0-4.5 per 100,000 per year) were similar to the incidence rate in Venezuela (0.03 per 100,000 per year) [ 85 ] and in Italy (0.31 per 100,000 per year) [ 86 ].…”

Section: Discussionmentioning

confidence: 70%

Review on epidemiology, disease burden, and treatment patterns of IgA nephropathy in select APAC countries

Zaidi,

Du,

Tang

et al. 2024

BMC Nephrol

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Background Immunoglobulin type A (IgA) nephropathy is the most common primary glomerulonephritis (GN) worldwide with higher rates in East and Pacific Asia compared to North America and Europe. Despite high reported prevalence of IgAN in these countries, the overall disease prevalence across Asia is not available. Treatment patterns of IgAN patients across Asian countries have also not been summarized. The aim of this study was to review and summarize evidence on IgA nephropathy prevalence, treatment patterns, and humanistic and economic burden in mainland China, Taiwan, South Korea, Japan, and Australia. Methods A targeted literature review was conducted in PubMed and local databases in China (including Taiwan), South Korea, Japan, and Australia between January 2010-December 2021. Website literature searches were conducted using Google Scholar and Baidu. Results Sixty-nine publications and 3 clinical guidelines were included. Incidence ranged from 0 to 10.7 per 100 000 people per year in Australia, Japan, and Taiwan, and ranged from 6.3 to 24.70% among patients who underwent renal biopsy in mainland China. Prevalence and diagnosis rates ranged from 0 to 72.1% in mainland China, South Korea, Taiwan, Japan, and Australia. Mortality rates in mainland China, South Korea, and Japan varied widely. The top 3 commonly used therapies were angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (0.9-99.6%), corticosteroids (3.5-100%), and immunosuppressants (1.6-85.5%) in Japan, mainland China, and South Korea. Patient quality of life was measured by different tools, and annual hospitalization costs ranged from $1 284.73 to $2 252.12 (2015–2018) in China. Conclusions The prevalence of IgA nephropathy among the general population in select countries/regions is not commonly available, despite evidence from studies and clinical guidelines. In addition, it is observed across geographic regions that heterogeneity exists in prevalence rates, and large variations exist in treatment patterns. There is need to fill in these gaps to understand the contributing factors behind the differences through population-based, multi-center, and real-world studies.

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Section: Discussionmentioning

confidence: 70%

Review on epidemiology, disease burden, and treatment patterns of IgA nephropathy in select APAC countries

Zaidi,

Du,

Tang

et al. 2024

BMC Nephrol

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“…Moreover, the incidence of IgAN varies significantly by country. 19,41 Even if we allow for the possibility of underestimation owing to the lack of screening and differences in biopsy selection practices, incidence rates outside Asia, particularly in the US and Europe, may be considerably lower than rates used in this study. Additionally, when urinary screening is introduced in a country, costs initially increase due to costs associated with building a new system; these costs were not included in this analysis.…”

Section: Discussionmentioning

confidence: 79%

Cost-Effectiveness of School Urinary Screening for Early Detection of IgA Nephropathy in Japan

Honda,

Akune,

Goto

2024

JAMA Netw Open

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ImportanceThe evidence for and against screening for chronic kidney disease in youths who are asymptomatic is inconsistent worldwide. Japan has been conducting urinary screening in students for 50 years, allowing for a full economic evaluation that includes the clinical benefits of early detection and intervention for chronic kidney disease.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of school urinary screening in Japan, with a focus on the benefits of the early detection and intervention for IgA nephropathy, and to explore key points in the model that are associated with the cost-effectiveness of the school urinary screening program.Design, Setting, and ParticipantsThis economic evaluation with a cost-effectiveness analysis used a computer-simulated Markov model from the health care payer’s perspective among a hypothetical cohort of 1 000 000 youths aged 6 years in first grade in Japanese elementary schools, followed up through junior and high school. The time horizon was lifetime. Costs and clinical outcomes were discounted at a rate of 2% per year. Costs were calculated in Japanese yen and 2020 US dollars (¥107 = US $1).InterventionsSchool urinary screening for IgA nephropathy was compared with no screening.Main Outcomes and MeasuresOutcomes were costs and quality-adjusted life-years (QALYs). Cost-effectiveness was determined by evaluating whether the incremental cost-effectiveness ratio (ICER) per QALY gained remained less than ¥7 500 000 (US $70 093).ResultsIn the base case analysis, the ICER was ¥4 186 642 (US $39 127)/QALY, which was less than the threshold. There were 60.3 patients/1 000 000 patients in the no-screening strategy and 31.7 patients/1 000 000 patients in the screening strategy with an end-stage kidney disease. Cost-effectiveness improved as the number of screenings decreased (screening frequency &lt;3 times: incremental cost, −¥75 [US $0.7]; incremental QALY, 0.00025; ICER, dominant), but the number of patients with end-stage kidney disease due to IgA nephropathy increased (40.9 patients/1 000 000 patients). Assuming the disutility due to false positives had a significant impact on the analysis; assuming a disutility of 0.01 or more, the population with no IgA nephropathy had an ICER greater than the threshold (¥8 304 093 [US $77 608]/QALY).Conclusions and RelevanceThis study found that Japanese school urinary screening was cost-effective, suggesting that it may be worthy of resource allocation. Key factors associated with cost-effectiveness were screening cost, the probability of incident detection outside of screening, and IgA nephropathy incidence, which may provide clues to decision-makers in other countries when evaluating the program in their own context.

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“…Ideally, such studies would be longitudinal, would be conducted in diverse background populations, would use a unified classification system for IgA nephropathy, and would have similar access to kidney biopsy among those with suspected IgA nephropathy regardless of race. 27…”

Section: Resultsmentioning

confidence: 99%

Global Incidence of IgA Nephropathy by Race and Ethnicity: A Systematic Review

et al. 2023

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Background The reported incidence of IgA nephropathy (IgAN) varies widely across studies and may vary based on race/ethnicity. This study systematically reviewed the incidence of IgAN in the United States (US) and other countries and explored variability based on the racial/ethnic composition and other demographic characteristics of different populations. Methods This was a systematic review. Studies were eligible for inclusion if they contained data collected from January 1, 1974 to December 31, 2021 and reported IgAN incidence at a population level (i.e., cases of IgAN per 100,000 population). Results Five US and sixteen international studies were included; three of the US studies reported the race-specific incidence of IgAN. In the US, the reported incidence of IgAN ranged from 0.39 per 100,000 in Tennessee to 1.4 per 100,000 in Minnesota; internationally, IgAN ranged from 0.06 per 100,000 in South Africa to 4.2 per 100,000 in Japan. Findings regarding the incidence of IgAN in the US by race were inconsistent: one study found a higher incidence among Whites compared to Blacks, one study found a lower incidence in Whites, and one study found no difference. Globally, the incidence of IgAN appeared to be higher in Asian than in non-Asian populations and higher in males than in females. Conclusions Reported incidence of IgAN varies widely; there is no consensus regarding the relationship between race and IgAN. Incidence rates appeared to be higher in Asians than non-Asians, and in males than females. We recommend that future studies should report IgAN incidence rates by race/ethnicity and account for the demographic characteristics of the background population.

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A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy

Cited by 34 publications

References 65 publications

Review on epidemiology, disease burden, and treatment patterns of IgA nephropathy in select APAC countries

Review on epidemiology, disease burden, and treatment patterns of IgA nephropathy in select APAC countries

Cost-Effectiveness of School Urinary Screening for Early Detection of IgA Nephropathy in Japan

Global Incidence of IgA Nephropathy by Race and Ethnicity: A Systematic Review

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