Global incidence and prevalence of bullous pemphigoid: A systematic review and meta‐analysis

Abstract

Background Integrated information on the global prevalence and incidence of bullous pemphigoid (BP) is lacking. Objective To estimate the incidence and prevalence of BP in a systematic review and meta‐analysis. Methods Observational studies were included by using databases of Medline, EMBASE, and Cochrane Library. Subgroup analysis was by continent, age, sex, and country income level. Random‐effects model was used. Between‐study heterogeneity was assessed using the I2 statistic. Results The global incidence was 0.0419 per 1000 person‐years (95% CI: 0.0414–0.0424). The incidence was 0.047 per 1000 person‐years (95% CI: 0.0462–0.0477), 0.0419 per 1000 person‐years (95% CI: 0.0411–0.0426), 0.0072 per 1000 person‐years (95% CI: 0.0067–0.0078), 0.003 per 1000 person‐years (95% CI: 0.0023–0.0039) in North America, Europe, Asia, and Africa, respectively; 0.0202 per 1000 person‐years (95% CI: 0.0196–0.0208) and 0.0181 per 1000 person‐years (95% CI: 0.0175–0.0188) females and males; 0.001 per 1000 person‐years (95% CI: 0.001–0.001), 0.002 per 1000 person‐years (95% CI: 0.001–0.002), 0.004 per 1000 person‐years (95% CI: 0.004–0.004); 0.007 per 1000 person‐years (95% CI: 0.007–0.008), 0.011 per 1000 person‐years (95% CI: 0.011–0.012), 0.017 per 1000 person‐years (95% CI: 0.015–0.018) for age <50, 50–59, 60–69, 70–79, 80–89, and ≥90 years; 0.0038 per 1000 person‐years (95% CI: 0.0036–0.004112) (I2 = 99%, p < .05) and 0.0456 per 1000 person‐years (95% CI: 0.0450–0.0462) (I2 = 100%, p < .05). The pooled clinic‐based prevalence was 0.79% (95% CI: 0.75%–0.84%), 1.13% (95% CI: 1.06%–1.21%), 0.21% (95% CI: 0.17%–0.26%), and 0.13% (95% CI: 0.1%–0.15%) for Asia, Africa, and Europe. Conclusions This study identified the global incidence and prevalence of BP in terms of spatial and population distributions and among various income level. A relatively higher incidence was in Europe, females, older people, and high‐income level country. The prevalence was higher in Asia. These findings should be interpreted with caution due to high heterogeneity of included studies.

Analysis of the clinical characteristics of pembrolizumab-induced bullous pemphigoid

“…Age is frequently seen as a risk factor for BP (54). According to several previous studies, the prevalence of BP rises progressively and considerably with age in the general population, notably in people over 70 (3,(62)(63)(64). According to Lu et al, age-specific incidence increased across all age groups.…”

“…Clinically, patients with BP often present with tense blister formation and symptoms of severe pruritus over urticarial plaques on the trunk and extremities (2). According to by Lu et al, the overall incidence was 4.19 per 100 000 person-years (3). Additionally, the prevalence of BP rises dramatically with aging and is most common among the elderly (4)(5)(6).…”

Case Report: Omalizumab Successfully Treated Recalcitrant Bullous Pemphigoid in an Elderly Patient with Multiple Comorbidities

“…The global incidence of bullous pemphigoid is 0.0419 per 1000 person-years. 6 BP has been reported to be significantly associated with mortality, with 1-year mortality rates ranging from 6% to 41%. 7 Two studies based on Chinese hospitals reported 1-year mortality rates of 12.9% and 23.4%, respectively.…”

Self-reactive IgE and anti-IgE therapy in autoimmune diseases

“…Bullous pemphigoid belongs to a group of subepidermal autoimmune blistering diseases, mainly affects elderly persons over 65 years of age, and is characterized by damage to the protein constituents of the basement membrane zone (BMZ). The incidence of BP is 6 times higher in North America and Europe when compared to Asia ( Lu et al, 2022 ). The pathogenesis of BP is associated with the presence of autoantibodies directed againts hemidesmosomal proteins: BP antigen 2 (BPAG2/BP180, a transmembrane glycoprotein, type VII collagen) and the intracellular BP antigen 1 (BPAG1/BP230) located on the BMZ in the skin and mucous membranes ( Kayani and Aslam, 2017 ).…”