Amyloidosis is rare. Immunoglobulin light chain (AL) amyloidosis is the most common type.[4]Wechalekar AD, Gillmore JD, Hawkins PN. Systemic amyloidosis. Lancet. 2016 Jun 25;387(10038):2641-54.
http://www.ncbi.nlm.nih.gov/pubmed/26719234?tool=bestpractice.com
Worldwide, the crude annual incidence of AL amyloidosis is estimated at 10.44 cases per million population (PMP), ranging from 6.72 PMP in Brazil to 14.3 PMP in Japan.[5]Kumar N, Zhang NJ, Cherepanov D, et al. Global epidemiology of amyloid light-chain amyloidosis. Orphanet J Rare Dis. 2022 Jul 19;17(1):278.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9295439
http://www.ncbi.nlm.nih.gov/pubmed/35854312?tool=bestpractice.com
One US-based study reported an increase in prevalence of AL amyloidosis from 15.5 cases per million in 2007 to 40.5 cases per million in 2015.[6]Quock TP, Yan T, Chang E, et al. Epidemiology of AL amyloidosis: a real-world study using US claims data. Blood Adv. 2018 May 22;2(10):1046-53.
http://www.bloodadvances.org/content/2/10/1046.long?sso-checked=true
http://www.ncbi.nlm.nih.gov/pubmed/29748430?tool=bestpractice.com
The prevalence and incidence of AL amyloidosis is higher in males than in females.[6]Quock TP, Yan T, Chang E, et al. Epidemiology of AL amyloidosis: a real-world study using US claims data. Blood Adv. 2018 May 22;2(10):1046-53.
http://www.bloodadvances.org/content/2/10/1046.long?sso-checked=true
http://www.ncbi.nlm.nih.gov/pubmed/29748430?tool=bestpractice.com
Average age at diagnosis is reported to be between 63 and 65 years, but patients can present at any age.[6]Quock TP, Yan T, Chang E, et al. Epidemiology of AL amyloidosis: a real-world study using US claims data. Blood Adv. 2018 May 22;2(10):1046-53.
http://www.bloodadvances.org/content/2/10/1046.long?sso-checked=true
http://www.ncbi.nlm.nih.gov/pubmed/29748430?tool=bestpractice.com
[7]Bergesio F, Ciciani AM, Santostefano M, et al. Renal involvement in systemic amyloidosis - an Italian retrospective study on epidemiological and clinical data at diagnosis. Nephrol Dial Transplant. 2007 Jun;22(6):1608-18.
http://www.ncbi.nlm.nih.gov/pubmed/17395661?tool=bestpractice.com
Studies assessing ethnic disparities in AL amyloidosis are sparse. Potential underdetection of cardiac amyloidosis among black Americans has been reported in one cohort study.[8]Alexander KM, Orav J, Singh A, et al. Geographic disparities in reported US amyloidosis mortality from 1979 to 2015: potential underdetection of cardiac amyloidosis. JAMA Cardiol. 2018 Sep 1;3(9):865-70.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233639
http://www.ncbi.nlm.nih.gov/pubmed/30046835?tool=bestpractice.com
In another cohort of US patients with AL amyloidosis, self-identified ethnic minorities (including non-Hispanic black and Hispanic) accounted for 334 (14%) of 2416 patients from a single referral centre. This percentage is lower than the reported >36% representation of racial/ethnic minorities in the US general population, suggesting underdetection of AL amyloidosis among ethnic minorities.[9]Staron A, Connors LH, Zheng L, et al. Race/ethnicity in systemic AL amyloidosis: perspectives on disease and outcome disparities. Blood Cancer J. 2020 Nov 10;10(11):118.
https://www.doi.org/10.1038/s41408-020-00385-0
http://www.ncbi.nlm.nih.gov/pubmed/33173025?tool=bestpractice.com
Of note, the incidence of multiple myeloma and monoclonal gammopathy of undetermined significance (MGUS), both closely related to amyloidosis, is approximately two- to threefold greater in black people than in white people.[10]National Cancer Institute: Surveillance, Epidemiology, and End Results Program. Cancer stat facts: myeloma [internet publication].
https://seer.cancer.gov/statfacts/html/mulmy.html
[11]Wadhera RK, Rajkumar SV. Prevalence of monoclonal gammopathy of undetermined significance: a systematic review. Mayo Clin Proc. 2010 Oct;85(10):933-42.
http://www.ncbi.nlm.nih.gov/pubmed/20713974?tool=bestpractice.com
[12]Landgren O, Weiss BM. Patterns of monoclonal gammopathy of undetermined significance and multiple myeloma in various ethnic/racial groups: support for genetic factors in pathogenesis. Leukemia. 2009 Oct;23(10):1691-7.
https://www.nature.com/articles/leu2009134
http://www.ncbi.nlm.nih.gov/pubmed/19587704?tool=bestpractice.com
The incidence of monoclonal gammopathy disorders is lower in Asian people compared with white people.[12]Landgren O, Weiss BM. Patterns of monoclonal gammopathy of undetermined significance and multiple myeloma in various ethnic/racial groups: support for genetic factors in pathogenesis. Leukemia. 2009 Oct;23(10):1691-7.
https://www.nature.com/articles/leu2009134
http://www.ncbi.nlm.nih.gov/pubmed/19587704?tool=bestpractice.com
Transthyretin (TTR) amyloidosis has historically been considered a rare condition. Precise estimates of incidence and prevalence are not available, but growing evidence suggests that it is more common than previously assumed and often goes undiagnosed in patients with cardiomyopathy.[13]Porcari A, Razvi Y, Masi A, et al. Prevalence, characteristics and outcomes of older patients with hereditary versus wild-type transthyretin amyloid cardiomyopathy. Eur J Heart Fail. 2023 Apr;25(4):515-24.
https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2776
http://www.ncbi.nlm.nih.gov/pubmed/36644836?tool=bestpractice.com
[14]Ruberg FL, Grogan M, Hanna M, et al. Transthyretin amyloid cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2019 Jun 11;73(22):2872-91.
https://www.sciencedirect.com/science/article/pii/S0735109719347291?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/31171094?tool=bestpractice.com
The incidence of secondary (AA) amyloidosis in the Western world has been falling, possibly due to advances in treatment for chronic inflammatory diseases.[15]Hazenberg BP, van Rijswijk MH. Where has secondary amyloid gone? Ann Rheum Dis. 2000 Aug;59(8):577-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1753216/pdf/v059p00577.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10913049?tool=bestpractice.com
[16]Lachmann HJ, Goodman HJB, Gilbertson JA, et al. Natural history and outcome in systemic AA amyloidosis. N Engl J Med. 2007 Jun 7;356(23):2361-71.
https://www.nejm.org/doi/10.1056/NEJMoa070265
http://www.ncbi.nlm.nih.gov/pubmed/17554117?tool=bestpractice.com
[17]Lane T, Pinney JH, Gilbertson JA, et al. Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre. Amyloid. 2017 Sep;24(3):162-6.
http://www.ncbi.nlm.nih.gov/pubmed/28686088?tool=bestpractice.com
Epidemiological study data indicate that, in 2008, AA amyloidosis accounted for approximately 18% of incident systemic amyloidoses in England.[18]Pinney JH, Smith CJ, Taube JB, et al. Systemic amyloidosis in England: an epidemiological study. Br J Haematol. 2013 May;161(4):525-32.
https://www.doi.org/10.1111/bjh.12286
http://www.ncbi.nlm.nih.gov/pubmed/23480608?tool=bestpractice.com