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PSC more common among African-Americans than previously thought

Recent data revealed that primary sclerosing cholangitis occurs more frequently among African-Americans than previously published studies have shown.

“Although these data do not demonstrate that PSC is as common in black and white patients, PSC in blacks is not as rare as what would be interpreted based on published data,” David Goldberg, MD, MSCE, and colleagues wrote. “This suggests that existing literature may reflect selection bias related to the demographics of the underlying population from where these studies emerge, rather than a clinical disease largely restricted to white patients.”

The researchers designed a cross-sectional study of North American centers that participate in the Consortium for Autoimmune Liver Disease to clarify the demographics of patients with PSC. The study included 2,241 patients with PSC, of whom 193 were African-American.

The median age at diagnosis among the African-American patients was 38 years (range, 23-47 years), 51.3% were men and 58.8% had inflammatory bowel disease. Ninety-six of the 184 African-Americans with PSC and available data had isolated intra-hepatic bile duct involvement on cholangiography, 56 has intra- and extra-hepatic bile duct involvement, and six had small-duct PSC.

Among the African-American patients with PSC, the incidence rates of the composite endpoint of transplant, cholangiocarcinoma or death was 6.58 events per 100 person-years (95% CI, 5.3-8.16), 6.31 events per 100 person-years (95% CI, 5.06-7.85) for commonly reported clinical event of transplant or death, and 0.55 events per 100 person-years (95% CI, 0.26-1.16) for cholangiocarcinoma.

“Ultimately,” the researchers wrote, “these results highlight the need for caution when generalizing findings in rare diseases derived from demographically homogenous groups, and the importance of conducting epidemiological studies of diverse populations that represent the demographics of the U.S. population.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.