Studies Explore Racial Disparities in IBD and Therapy

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LAS VEGAS—Three separate studies presented recently at the American College of Gastroenterology’s (ACG) 77th Annual Scientific meeting in Las Vegas help to advance understanding of the differences between African American and Caucasian patients with Inflammatory Bowel Disease (IBD) and provide clinicians with new insight on how racial disparities involving disease characteristics, infliximab use, and fistulizing Crohn’s disease may impact their patients—and their decisions on how best to manage the disease.

The incidence of inflammatory bowel disease (IBD) in non-Caucasian minority groups, including African-Americans (AA), appears to be increasing but there is limited understanding of phenotypic differences and outcomes by race, according to researchers from the University of Chicago who describe disease characteristics of both groups in a retrospective review, “Comparing Disease Characteristics between African-American and Caucasian Inflammatory Bowel Disease Patients."

“This study analyzed our large IBD registry and looked at the type of diseases seen in the African Americans (self-described) compared to Caucasians," said co-investigator David Rubin, MD, FACG. “It is one of the largest studies of African Americans with IBD, and we identified a few important differences in this population. First, they were more likely to have extra-intestinal manifestations of their IBD, including joint pain and skin inflammation. Secondly, in the Crohn’s patients, they were less likely to have small intestinal involvement."

For Crohn's disease (CD) patients, 797 Caucasians and 86 African Americans were identified. For ulcerative colitis (UC) patients, 345 Caucasians and 19 African Americans were identified. Among CD patients, African Americans had significantly higher rates of joint symptoms (31.2 percent vs. 20.1 percent) and pyoderma gangrenosum (3.5 percent vs. 1.1 percent) compared to Caucasian patients. African American Crohn’s disease patients also had a significantly lower rate of ileal involvement (45.4 percent vs. 60.4 percent) compared to Caucasian patients, but no difference in rates of upper gastrointestinal, jejunal, colonic, or perianal disease.

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