Systemic sclerosis severity, prognosis worse among Black patients
Click Here to Manage Email Alerts
Black patients with systemic sclerosis had multiple poor prognostic features compared with non-Black patients, putting them at higher risk for mortality, according to data presented at ACR Convergence 2021.
“Systemic sclerosis, or scleroderma, is a rare autoimmune disease that disproportionately affects women and similar to other chronic diseases, health disparities have been noted in systemic sclerosis, with African American patients experiencing poor outcomes more frequently than patients from other ethnic or racial groups,” study coauthor, Sarah M. Compton, MD, a rheumatologist at Medical University of South Carolina, said during a press conference.
Researchers collected data on patients with systemic sclerosis, including demographics, clinical manifestations and medical history, as part of an ongoing IRB-approved longitudinal registry. Using retrospective chart review, the researchers confirmed age at onset, disease type, and selected criteria to determine severity among patients seen at a single academic center over a 16-year period.
Overall, 372 patients (79.6% women and 37.9% Black) with systemic sclerosis were included. The researchers noted Black patients had significantly younger age at onset compared with non-Black patients (41.8 years vs. 48.9 years; P < .0001), with women developing systemic sclerosis at a younger age than men (45.4 years vs. 50.2 years; P < .01).
When comparing outcomes for diffuse cutaneous systemic sclerosis, the risk for renal crisis, interstitial lung disease and restrictive lung disease were statistically significant. Among Black patients, risks for all outcomes (death, pulmonary hypertension, ILD, restrictive lung disease, malignancy, diffuse disease) were statistically significant compared with non-Black patients, except for renal crisis.
Researchers examined two social determinants — private insurance status and high school graduation — and found a significant difference between Black and non-Black patients: 43.75% vs. 66.83% with private insurance; P < .0001 and 89.82% vs. 96.39% high school graduates; P < .05.
Additionally, men had significantly higher rates than women of diffuse disease, dysphagia and restrictive lung disease.
“We hope with further research, answers will be elucidated as to why African American patients have worse disease characteristics,” Compton said. “So, then we can intervene ... earlier or differently to improve patient outcomes.”
Collapse
Compton S. Abstract #1854. Presented at: ACR Convergence 2021; November 5-9, 2021 (virtual meeting).
Read more about
Click Here to Manage Email Alerts