Endocrine Abstracts

Introduction: There is variation in Paget’s disease occurrence in different regions/populations. We looked at Paget’s occurrence (GP-coded diagnosis) in a large UK urban conurbation and explored the influence of age/gender/ethnicity on occurrence. We also looked at the impact of Paget’s disease on the severity of COVID-19 infection.

Methods: We undertook an anonymised search using an integrated primary/secondary care-based database in Greater Manchester (GMCR), covering a population of 2.85million people. We looked at the occurrence of clinically diagnosed Paget’s disease in January 2020 in men/women over 60 years old by age/gender/deprivation level (assessed using the Townsend-Index and expressed in quintiles), and ethnicity (based on self-report).

Results: We identifed 534,571 people aged ≥60years on 1January 2020. The majority were white (84%): 4.7% describing themselves as Asian/Asian British; 1.27% Black/Black British. There were 931 with clinically diagnosed Paget’s disease. Overall prevalence in the GM area was 0.174%. Prevalence was higher in menvswomen (0.195vs0.155%). Compared to the prevalence of Paget’s in whites (0.179%) the prevalence was lower in those of Asian/South Asian descent (0.048%) and higher in those of Black/Black British descent (0.344%). Prevalence increased with increasing deprivation. After adjustment for age/gender/deprivation the risk of disease remained lower in Asians (OR=0.36) and higher in Black British (OR=2.13). Among those with a positive COVID-19 test those with Paget’s disease were more likely to require hospital admission within 28-days. However confidence intervals embraced unity (OR1.37; 95% CI (0.94,1.95).

Conclusion: Clinically apparent Paget’s disease is uncommon affecting less than 2 per thousand men/women over 60-years old. Within GM, it is more common in those of Black-British descent and less common in those of South-Asian descent. Further research is required to determine whether such differences are due to variation in disease occurrence or disease presentation.