Edward L Barnes1,2, Bharati Kochar1,2, Millie D Long1,2,3, Joel Pekow4, Ashwin Ananthakrishnan5, Adjoa Anyane-Yeboa4, Christopher Martin1,3, Joseph Galanko3, Hans H Herfarth1,2,3, Michael D Kappelman1,2,3, Robert S Sandler1,3. 1. Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 2. Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 3. Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, Illinois. 5. Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Abstract
Background: Previous reports have shown differences in phenotypes among black patients with inflammatory bowel disease (IBD) compared with other racial groups, but prior studies were limited by small numbers of black patients and cross-sectional analyses. We used data from the Sinai-Helmsley Alliance for Research Excellence cohort to compare phenotypes and treatment patterns of black and white patients with IBD in a prospective study. Methods: We compared phenotypes, IBD-specific therapies, and health care utilization among black and white patients with IBD. For all analyses, we performed bivariate analyses and multivariable logistic regression to adjust for potential confounders. Results: Among 5537 patients with IBD, 314 (6%) reported black race. Black patients were more likely to report a Crohn's disease (CD)-related complication at baseline (adjusted odds ratio [aOR], 1.44; 95% confidence interval [CI], 1.06-1.95). Black patients with CD were more likely to develop a new abscess (aOR, 2.27; 95% CI, 1.31-3.93) and initiate an anti-tumor necrosis factor therapy during follow-up (aOR, 1.85; 95% CI, 1.09-3.14). Black patients with ulcerative colitis were more likely to have proctitis (24% vs 13%, P = 0.033) at baseline. There were no differences in surgery or hospitalization rates during the follow-up period. Conclusions: Black patients with CD demonstrated increased complications at baseline and during follow-up in this cohort. Despite more complicated disease, black and white patients with IBD were generally given the same medications and experienced similar rates of hospitalization and surgery during the study period. In our multicenter cohort, clinical outcomes among black and white patients with IBD were similar.
Background: Previous reports have shown differences in phenotypes among black patients with inflammatory bowel disease (IBD) compared with other racial groups, but prior studies were limited by small numbers of black patients and cross-sectional analyses. We used data from the Sinai-Helmsley Alliance for Research Excellence cohort to compare phenotypes and treatment patterns of black and whitepatients with IBD in a prospective study. Methods: We compared phenotypes, IBD-specific therapies, and health care utilization among black and whitepatients with IBD. For all analyses, we performed bivariate analyses and multivariable logistic regression to adjust for potential confounders. Results: Among 5537 patients with IBD, 314 (6%) reported black race. Black patients were more likely to report a Crohn's disease (CD)-related complication at baseline (adjusted odds ratio [aOR], 1.44; 95% confidence interval [CI], 1.06-1.95). Black patients with CD were more likely to develop a new abscess (aOR, 2.27; 95% CI, 1.31-3.93) and initiate an anti-tumornecrosis factor therapy during follow-up (aOR, 1.85; 95% CI, 1.09-3.14). Black patients with ulcerative colitis were more likely to have proctitis (24% vs 13%, P = 0.033) at baseline. There were no differences in surgery or hospitalization rates during the follow-up period. Conclusions: Black patients with CD demonstrated increased complications at baseline and during follow-up in this cohort. Despite more complicated disease, black and whitepatients with IBD were generally given the same medications and experienced similar rates of hospitalization and surgery during the study period. In our multicenter cohort, clinical outcomes among black and whitepatients with IBD were similar.
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