23 May Inflammatory Bowel Diseases Less Common Among Non-White and Hispanic Patients
MedicalResearch.com Interview with:
Edward L. Barnes, MD, MPH
Assistant Professor of Medicine
Division of Gastroenterology and Hepatology
UNCHealth Care and a medical advisor to the Global Healthy Living Foundation
MedicalResearch.com: What is the background for this study?
Response: Although historically inflammatory bowel diseases (IBDs) have been considered diseases of non-Hispanic whites, the current burden of Crohn’s disease (CD) and ulcerative colitis (UC) in minority populations is largely unknown. I
n our study, we evaluated the relative prevalence of CD and UC across racial and ethnic groups within the National Patient-Centered Clinical Research Network (PCORnet) and compared the racial/ethnic distribution of IBD in PCORnet to that of the United States (US) census data, the overall PCORnet population, and PCORnet patients with selected immune-mediated conditions.
MedicalResearch.com: What are the main findings?
Response: We found that:
- Relative to the overall PCORnet population, Black or African-American (AA) adult patients were significantly less likely than white patients to have a diagnosis of CD (OR 0.53, 95% CI 0.52 – 0.54, Table 2) or UC (OR 0.41, 95% CI 0.40 – 0.43). Pediatric AA patients were also less likely to have a diagnosis of CD (OR 0.41, 95% CI 0.39 – 0.43) or UC (OR 0.38, 95% CI 0.35 – 0.41) when compared to white patients.
- Adult Hispanic patients were also less likely to have a diagnosis of CD (OR 0.33, 95% CI 0.32 – 0.34) and UC (OR 0.45, 95% CI 0.44 – 0.46) compared to non-Hispanic patients. Similarly, pediatric Hispanic patients were less likely to have a diagnosis of CD (OR 0.34, 95% CI 0.32 – 0.36) and UC (OR 0.50, 95% CI 0.47 – 0.53).
- Native Americans or Alaskan Natives, Asians, and Pacific Islanders also experienced significantly fewer diagnoses of CD or UC.
MedicalResearch.com: What should readers take away from your report?
Response: The demographics of the US population are changing with increasing racial and ethnic diversity; however, CD and UC appear to be modestly less prevalent among patients of non-white races and Hispanic ethnicity. An improved understanding of the demographics and epidemiology of IBD among patients of different races and ethnicities will also enhance future studies of health equity in IBD and provide an improved framework for studies of clinical outcomes among patients with CD and UC.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Although our findings indicate that patients of non-white races and Hispanic ethnicity were less likely to have a diagnosis of CD or UC, we still have a great deal of work to do to improve health equity among all patients with IBD.
Access to care remains a barrier for many patients of minority races and Hispanic ethnicity, and thus future work should continue to evaluate the role that access to care has on IBD-related outcomes (and the impact that improving access care may have on the disease course). Additionally, our study did not evaluate important IBD-specific clinical details that may vary among patients of different races and ethnicities, including disease severity, phenotype, and medication use patterns, as well as any analyses of other socioeconomic factors that might influence IBD-related outcomes. However, by evaluating the prevalence of CD and UC in a large, geographically diverse network, we believe that these data may provide an important framework for future studies, evaluate the generalizability of published research, and may even inform recruitment targets for clinical trials.
- Edward L. Barnes has served as a consultant for AbbVie, Gilead, Pfizer, Takeda, and Target RWE.
- William B. Nowell and Shilpa Venkatachalam work for the non-profit Global Healthy Living Foundation which has received research support from Abbvie, Amgen, and Eli Lilly
- Angela Dobes has no relevant relationships to report.
- Michael D. Kappelman has consulted for Abbvie, Janssen, Pfizer, and Takeda, is a shareholder in Johnson & Johnson, and has received research support from Pfizer, Takeda, Janssen, Abbvie, Lilly, Genentech, Boehringer Ingelheim, Bristol Myers Squibb, Celtrion, and Arenapharm.
1) DDW 21 abstract
Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States
2) Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases
Barnes, Edward L. et al.
Gastroenterology, Volume 160, Issue 3, 677 – 689
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