Prevalence of immune thrombocytopenia: analyses of administrative data

Abstract

Summary. Background: The prevalence of immune thrombocytopenic purpura (ITP) in the USA is unknown. The paucity of data makes clinical trial design and resource allocation challenging. Objectives: We aimed to quantify the prevalence of ITP in one state and to report on utilization of resources. Methods: The Maryland Health Care Commission supplied utilization data on all privately insured Maryland residents in 2002. We identified patients having two claims, separated by at least 30 days, for International Classification of Diseases, Ninth Revision, Clinical Modification code 287.3 (expected to be predominantly ITP). We excluded patients with concurrent diagnoses that made ITP unlikely. In sensitivity analyses, we varied the required visit interval between 14 and 180 days. We quantified ITP prevalence, resource utilization, and prevalence of concurrent autoimmune illnesses. Results: The age‐adjusted prevalence of ITP was 9.5 per 100 000 persons (10.5 per 100 000 when requiring a minimum 14‐day interval and 4.5 per 100 000 with a 180‐day interval). There was a predominance of males in childhood and of females in the middle‐adult years, with an overall prevalence rate ratio of 1.9 for females to males. Twenty per cent of these patients were hospitalized, but emergency department use was rare, as was splenectomy. A concurrent diagnosis of multiple sclerosis was 25 times more prevalent than anticipated. Conclusions: We conclude that the prevalence of ITP in one populous state in the USA is comparable with that which has been reported in Europe. The suggested co‐occurrence of ITP and multiple sclerosis in children merits further investigation.

A Clinical Study of Patients With Idiopathic Thrombocytopenic Purpura

“…In 1735, a German physician Paul Gottlieb Werlhof described ITP nearly 10 decades before Victor Hugo's published his novel Les misérables. ITP has an incidence of 6/100000, and the licensing of thrombopoietin mimetic agents has added a good paradigm to its management [3,4]. Corticosteroids and intravenous immunoglobulins were the mainstay of immediate treatment after 1950's with splenectomy for more than 100 years remains the only option with curative potential.…”

Hospitalizations in pediatric patients with immune thrombocytopenia in the United States

“…Thrombocytopenia places patients at higher risk for minor and more serious bleeding, such as intracranial hemorrhage (ICH) [3]. Estimates of ITP incidence range between 2 and 5 cases per 100 000 per year in children who are younger than 15 years old [4][5][6]; prevalence estimates range between 4.1 and 12.6 cases per 100 000, depending on age, with a mean prevalence of approximately 7.2 cases per 100 000 in children younger than 18 years old [7][8]. Approximately 75% of pediatric ITP cases are newly diagnosed and persistent, with the remaining cases considered chronic [9][10][11][12].…”

Thromboembolic events among adult patients with primary immune thrombocytopenia in the United Kingdom General Practice Research Database

“…7 Literature on the descriptive epidemiology of primary immune thrombocytopenia is limited; a systematic review on autoimmune diseases conducted by Jacobsen et al in 1997 found no population-based studies on primary immune thrombocytopenia in the medical literature. 8 Four such studies have since been conducted and published; two in the United Kingdom (UK), [9][10] one in the United States, 11 and one in Denmark; 12 revealing an annual incidence of 1.6 to 3.2 cases per 100,000 adults. The investigations document an increased incidence of primary immune thrombocytopenia among the elderly and a moderate female preponderance noted to dissipate with age.…”