Trends and disparities in immune thrombocytopenic purpura-related mortality in the United States: a retrospective study over 24 years.

Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by thrombocytopenia in the absence of another cause. Our aim is to analyze mortality trends related to ITP in the United States (US) population from 1999 to 2022.

Methods: We extracted age-adjusted mortality rates (AAMR) per 100,000 population for ITP-related deaths in the United States from 1999 to 2022 using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2022. AAMRs were stratified by year, gender, race or ethnicity, and geographical distribution. Joinpoint regression was used to calculate annual percent change (APC) and average annual percent change (AAPC) through the Joinpoint Regression Program (V 5.1.0, National Cancer Institute).

Results: From 1999 to 2022, a total of 17,069 ITP-related deaths occurred in the US. Males exhibited a higher overall AAMR (0.22) in comparison to females (0.17). NH Whites exhibited the highest overall AAMR (0.20). Stratification by geographical location revealed non-metropolitan areas to have a higher overall AAMR (0.24) than metropolitan areas (0.19). The Midwest exhibited the highest overall AAMR (0.22). Vermont (0.37), Rhode Island (0.35), and North Dakota (0.32) were among the states with the highest overall AAMR, whereas states on the other end of the spectrum included Nevada (0.13), the District of Columbia (0.14) and Louisiana (0.15).

Conclusion: The disparities identified in our analysis, particularly among NH Whites, the elderly, and residents of the Midwest and rural areas, suggest underlying healthcare access issues, potential genetic predispositions, and regional differences in treatment strategies.