Alaska Native, American Indian populations show ‘high’ rates of ANCA-associated vasculitis
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WASHINGTON — Alaska Native and American Indian populations demonstrate notably higher prevalences of ANCA-associated vasculitis vs. white patients, according to data presented at ACR Convergence 2024.
“Our objective was to determine the prevalence and clinical characteristics of vasculitis in Alaska Native and American Indian peoples of Alaska,” Ben Henderson, a student at the University of Washington School of Medicine, told attendees.
The research presented is part of a larger study called Arthritis and Autoimmune Disease Epidemiology and Impact in the Alaska Native Population, funded by the NIH and established in 2019, according to lead study author Elizabeth D. Ferucci, MD, MPH, FACP, from Community Health Services at the Alaska Native Tribal Health Consortium.
“This overall study was designed to determine the prevalence of different forms of arthritis and autoimmune disease, as well as assess hospitalizations and joint replacements in people with arthritis,” Ferucci told Healio Rheumatology. “The study was designed to fill a gap in the literature, as few studies have investigated the prevalence and impact of arthritis and autoimmune diseases in the Alaska Native population. For vasculitis specifically, there are very limited studies in Alaska Native or American Indian populations, and the few that exist are outdated.”
The overall study population included 93,720 individuals, identified through the electronic health records of participating tribal health organizations within the Alaska Tribal Health System. Among 152 potential vasculitis diagnoses, 74 validated cases made the final analysis.
According to the researchers, the age-adjusted prevalence per 1,000,000 Alaska Native or American Indian adults was 752 for all vasculitis, 518 for systemic vasculitis, 189 for leukocytoclastic vasculitis (skin only), and 44 for drug-associated vasculitis. Among cases of systemic vasculitis, the most common forms were ANCA-associated vasculitis, at 340 per 1,000,000 adults, and giant cell arteritis, at 28 per 100,000 at or older than 50 years. Meanwhile, the most common subtype of ANCA-associated vasculitis was granulomatosis with polyangiitis (GPA), at 244 per 1,000,000 adults.
Diagnoses of ANCA-associated vasculitis were reported at a mean age of 54.2 years, commonly with high inflammatory markers and significant renal involvement, according to the researchers. GCA, meanwhile, was diagnosed at a mean age of 69.6 years.
Importantly, the rates of ANCA-associated vasculitis were higher among Alaska Native and American Indian individuals compared with previous data for white populations, according to the researchers.
“The prevalence of ANCA-associated vasculitis, especially GPA, in the Alaska Native/American Indian peoples of Alaska is high compared to other populations,” Henderson said. “The prevalence of GCA in the Alaska Native/American Indian peoples of Alaska is low, but higher than previously suggested.”
Henderson added that this patient population may present at a younger age and with more severe complications than other groups.
“Rheumatologists should be aware of the epidemiology of different rheumatic diseases in the Alaska Native/American Indian population,” Ferucci said. “This study documented higher rates of AAV and lower rates of GCA than found in other populations. These results should be taken in context with the known high rates of other rheumatic diseases in Alaska Native/American Indian populations, including rheumatoid arthritis and systemic lupus erythematosus.”
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Henderson B. Abstract #2554. Presented at: ACR Convergence 2024; Nov. 14-19, 2024; Washington, D.C.
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