Danish Study Assesses Mortality Rate in CAD and Related Disorders

Mortality rates are generally higher among people with cold agglutinin disease (CAD) and related conditions than in the general population, according to a recent study from Denmark.

These results highlight the need for better care for people with CAD, its authors noted.

The study, “Survival in autoimmune hemolytic anemia remains poor, results from a nationwide cohort with 37 years of follow-up,” was published in the European Journal of Haematology.

CAD is an autoimmune disease in which the body makes antibodies that destroy red blood cells at low temperatures. CAD is a form of autoimmune hemolytic anemia (AIHA), a broader category of autoimmune diseases that are characterized by red blood cell destruction.

Here, a trio of researchers in Denmark conducted a study to evaluate the survival outcomes of people with CAD and other forms of AIHA.

“We report on prognosis and death among patients with all types of AIHA in Denmark, 1980–2016, focusing on temporal changes in survival rates and causes of death,” the researchers wrote.

Their analysis included data from 2,650 people with AIHA — 1,460 with primary AIHA, 1,078 with secondary AIHA, and 112 with CAD. For comparison, the analysis also included data for 130,801 people without AIHA, who were matched to AIHA patients by age and sex.

Overall, the median survival time after diagnosis was 8.8 years among people with CAD. For primary AIHA, the median survival time was 9.8 years, and the median survival for secondary AIHA was 3.3 years.

“Both primary and secondary AIHA as well as CAD conferred reduced survival compared to age–sex-matched comparators from the general population, even when adjusted for comorbidities [other health conditions],” the researchers wrote.

They noted that patients with primary AIHA who were younger than 30 at diagnosis showed similar mortality outcomes to the comparators, but “the gap between patients with AIHA or CAD and their corresponding comparisons was considerable in all other age and subgroups.”

Common causes of death among patients with AIHA or CAD included blood cancers and infections. Researchers also noted that mortality rates tended to be highest in AIHA patients in the first year following diagnosis.

More detailed analyses indicated that survival times have generally increased in more recent years. For example, the median survival time for secondary AIHA patients diagnosed in the 1980s was 1.12 years, but in patients with the same condition diagnosed after 2000, median survival time had increased to 3.89 years.

“Taken together, our results emphasize an unmet need in management of patients with AIHA and CAD,” the researchers wrote.