Mortality of Bullous Pemphigoid in China

Li, Jun; Zuo, Ya‐Gang; Zheng, Heyi

doi:10.1001/archdermatol.2012.2994

Cited by 36 publications

(68 citation statements)

References 5 publications

(11 reference statements)

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“…15 Although only few studies have been conducted in Asian countries, 2 recent Chinese cohort studies reported 1-year mortality rates of patients with BP. 22,23 One study 23 showed a slightly higher mortality rate than our study (23.4%), while the other study from China 22 reported a significantly lower mortality rate (12.9%). However, the latter study's results are not necessarily comparable with those from other studies, because it included only hospitalized patients.…”

Section: Discussioncontrasting

confidence: 59%

“…For all age groups, the rate of observed deaths was higher than that expected for the general population, particularly in BP patients who were 60 to 80 years of age. Several cohort studies have reported that patients with BP have increased mortality, compared with ageadjusted general populations, 17,[19][20][21][22] with the exception of 1 study conducted in the United States, 15 which showed that the morality rate of patients with BP was not higher than that of the general population. Because the US study was a retrospective cohort study, the study might have selection bias.…”

Section: Discussionmentioning

confidence: 99%

“…13,[15][16][17][18][19][21][22][23] However, some of the data from these studies are based on 1-year mortality rate and others are based on overall mortality. Therefore, we analyzed prognostic factors associated with both 1-year and overall survival.…”

Section: Discussionmentioning

confidence: 99%

“…15,17,18,22,23 However, some of these studies have classified dementia, cerebrovascular disease, and psychosis collectively as neurologic disease. Therefore, in this study we analyzed There are some limitations to our study.…”

Section: Discussionmentioning

confidence: 99%

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Mortality of patients with bullous pemphigoid in Korea

Lee

Kim

2014

Journal of the American Academy of Dermatology

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mortality of patients with bullous pemphigoid in Korea

Lee

Kim

2014

Journal of the American Academy of Dermatology

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“…They found that, compared with age- and sex-matched controls, the presence of BP180 antibodies in patients with BP was associated with the diagnosis of dementia. Neurologic disorders have even been postulated as a cause of increasing mortality secondary to BP, although the mechanism underlying this proposition is unclear (28,29). One hypothesis is that those with BP and concomitant or subsequent neurologic disease have more severe disease on either front, leading to increased mortality while also favoring increased autoantibody cross-reactivity between the skin and brain.…”

Section: Discussionmentioning

confidence: 99%

A population-based study of the association between bullous pemphigoid and neurologic disorders

Brick

Weaver

Savica

et al. 2014

Journal of the American Academy of Dermatology

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Background Bullous pemphigoid has been reported in association with neurologic disorders. Objective To analyze the association between bullous pemphigoid and neurologic disorders. Methods We retrospectively identified residents of Olmsted County, Minnesota, with a first lifetime diagnosis of bullous pemphigoid between January 1, 1960, and December 31, 2009. Three age- and sex-matched Olmsted County residents without bullous pemphigoid were selected as controls for each patient. We compared history of or development of neurologic disorders (dementia, Alzheimer disease, Parkinson disease, multiple sclerosis, cerebrovascular disease, and seizures) between groups using case-control and cohort designs. Results A total of 87 patients with bullous pemphigoid were identified and matched to 261 controls. The odds of a previous diagnosis of any neurologic disorder or a history of dementia were significantly increased among cases compared with controls (odds ratios: 6.85 (3.00–15.64); P<.001, and 6.75 (2.08–21.92); P=.002, respectively). Both Parkinson disease (hazard ratio, 8.56 (1.55–47.25); P=.01) and any type of neurologic disorder (hazard ratio, 2.02 (1.17–3.49); P=.01) were significantly more likely to develop during follow-up in patients with bullous pemphigoid than in those without bullous pemphigoid. Limitations Small geographic area; retrospective study design. Conclusion Our study confirmed an association of bullous pemphigoid with neurologic disorders, especially dementia and Parkinson disease.

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Mixed Individual-Aggregate Data on All-Cause Mortality in Bullous Pemphigoid

et al. 2021

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The 1-year standardized mortality ratio (SMR) of bullous pemphigoid (BP) has been reported as 2.15 to 7.56 and lower in the US than in Europe.OBJECTIVE To estimate the worldwide 1-year SMR of BP.DATA SOURCES PubMed, Embase, Cochrane Library, Google Scholar, Lissa, and gray literature (eg, medRxiv) were screened for studies of BP published from inception to June 10, 2020, with review of reference lists. STUDY SELECTIONRetrospective and prospective studies reporting 1-year all-cause mortality rate in patients with BP and providing age statistics (eg, mean [SD]).DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted the data. The 1-year SMR was computed in studies reporting 1-year mortality by combining information on age obtained from studies with aggregate data and individual data. Risk of representativity, misclassification, and attrition bias were assessed by a custom tool. MAIN OUTCOMES AND MEASURESThe primary end point was the worldwide 1-year SMR. Secondary analysis included comparison of 1-year SMRs between continents in a meta-regression.RESULTS Three studies were performed in the US (n = 260), 1 in South America (n = 45), 16 in Asia (n = 1903), and 36 in Europe (n = 10 132) for a total of 56 unique studies and 12 340 unique patients included in the meta-analysis (mean [SD] age, 77.3 [12.7] years; 55.9% women). The mean (SD) patient age in the United States was 75.6 (13.7) years; in Asia, 73.8 (13.6) years; and in Europe, 78.1 (12.3) years. The worldwide 1-year SMR was estimated at 2.93 (95% CI, 2.59-3.28; I 2 = 85.6%) for all 56 studies. The 1-year SMR in the US was 2.40 (95% CI, 0.89-3.90; I 2 = 86.3%) for 3 studies; in Asia, 3.53 (95% CI, 2.85-4.20; I 2 = 86.3%) for 16 studies; and in Europe, 2.77 (95% CI, 2.35-3.19; I 2 = 86.3%) for 36 studies. After adjustment on the expected 1-year mortality rate, the European 1-year SMR did not differ significantly from the 1-year SMR in the United States (−0.48 vs Europe; 95% CI, −2.09 to 1.14; P = .56) and Asia (0.51 vs Europe; 95% CI, −0.56 to 1.58; P = .35). Risk of attrition bias was high (>10% censorship) in 16 studies (28.6%), low in 16 (28.6%), and unclear in 24 (42.9%). Only 4 studies (7.1%) had a sampling method guaranteeing the representativity of BP cases in a population.CONCLUSIONS AND RELEVANCE Although heterogeneity was high and overall quality of follow-up was poor, this meta-analysis confirms the high mortality rate among patients with BP.

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Mortality of Bullous Pemphigoid in China

Cited by 36 publications

References 5 publications

Mortality of patients with bullous pemphigoid in Korea

Mortality of patients with bullous pemphigoid in Korea

A population-based study of the association between bullous pemphigoid and neurologic disorders

Mixed Individual-Aggregate Data on All-Cause Mortality in Bullous Pemphigoid

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