eprintid: 10052925 rev_number: 21 eprint_status: archive userid: 608 dir: disk0/10/05/29/25 datestamp: 2018-07-20 13:06:12 lastmod: 2021-09-25 23:00:44 status_changed: 2018-07-20 13:06:12 type: article metadata_visibility: show creators_name: Lane, T creators_name: Pinney, JH creators_name: Gilbertson, JA creators_name: Hutt, DF creators_name: Rowczenio, DM creators_name: Mahmood, S creators_name: Sachchithanantham, S creators_name: Fontana, M creators_name: Youngstein, T creators_name: Quarta, CC creators_name: Wechalekar, AD creators_name: Gillmore, JD creators_name: Hawkins, PN creators_name: Lachmann, HJ title: Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 keywords: AA amyloidosis, systemic amyloidosis, epidemiology, inflammation, renal failure note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Objective: Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. // Methods: We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990–1997; C2: 1998–2006; C3: 2007–2014. // Results: Mean age at presentation increased from 46 in C1 to 56 in C3 (p < .0001). The proportion of South Asian patients increased from 4% in C1 to 17% in C3 (p = .0006). Comparison of underlying diseases between C1 and C3 revealed a reduction in patients with juvenile idiopathic arthritis from 25% to 2% (p < .0001), but an increase in patients with chronic infection due to intravenous recreational drug use from 1% to 13% (p < .0001), and uncharacterized inflammatory disorders from 10% to 27% (p <.0001). More patients were in end-stage renal failure at presentation in C3 (29%) than C1 (15%) (p = .0028). Median age at death was later in C3 (62 years) than C1 (54 years) (p = .0012). // Conclusion: These data suggest both falling incidence and better outcome in AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival. date: 2017 date_type: published publisher: TAYLOR & FRANCIS LTD official_url: https://doi.org/10.1080/13506129.2017.1342235 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green article_type_text: Article verified: verified_manual elements_id: 1301576 doi: 10.1080/13506129.2017.1342235 lyricists_name: Fontana, Marianna lyricists_name: Gilbertson, Janet lyricists_name: Gillmore, Julian lyricists_name: Hawkins, Philip lyricists_name: Hutt, David lyricists_name: Lachmann, Helen lyricists_name: Lane, Thirusha lyricists_name: Mahmood, Ayesha lyricists_name: Quarta, Candida lyricists_name: Rowczenio, Dorota lyricists_name: Sachchithanantham, Sajitha lyricists_name: Wechalekar, Ashutosh lyricists_name: Youngstein, Taryn lyricists_id: MFONT56 lyricists_id: JAGIL44 lyricists_id: JGILL78 lyricists_id: PNHAW77 lyricists_id: DHUTT57 lyricists_id: HJLAC80 lyricists_id: TLANE58 lyricists_id: AMAHM84 lyricists_id: CCQUA74 lyricists_id: DROWC07 lyricists_id: SSACH22 lyricists_id: AWECH53 lyricists_id: TABYO89 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Amyloid: The Journal of Protein Folding Disorders volume: 24 number: 3 pagerange: 162-166 pages: 5 issn: 1744-2818 citation: Lane, T; Pinney, JH; Gilbertson, JA; Hutt, DF; Rowczenio, DM; Mahmood, S; Sachchithanantham, S; ... Lachmann, HJ; + view all <#> Lane, T; Pinney, JH; Gilbertson, JA; Hutt, DF; Rowczenio, DM; Mahmood, S; Sachchithanantham, S; Fontana, M; Youngstein, T; Quarta, CC; Wechalekar, AD; Gillmore, JD; Hawkins, PN; Lachmann, HJ; - view fewer <#> (2017) Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre. Amyloid: The Journal of Protein Folding Disorders , 24 (3) pp. 162-166. 10.1080/13506129.2017.1342235 <https://doi.org/10.1080/13506129.2017.1342235>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10052925/1/Lane_Changing%20Epidemiology%20of%20AA%20Amyloidosis.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10052925/8/Lane_Changing%20Epidemiology%20of%20AA%20Amyloidosis_figs.zip