Comparison of the natural history of ulcerative colitis in African Americans and non-Hispanic Caucasians: A historical cohort study

Authors

  • Lauren Moore MD, MA,

    1. Departments of Gastroenterology and Quantitative Health Sciences and the Cleveland Clinic Lerner College of Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio
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  • Kristin Gaffney DO,

    1. Departments of Gastroenterology and Quantitative Health Sciences and the Cleveland Clinic Lerner College of Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio
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  • Rocio Lopez MS, MPH,

    1. Departments of Gastroenterology and Quantitative Health Sciences and the Cleveland Clinic Lerner College of Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio
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  • Bo Shen MD

    Corresponding author
    1. Departments of Gastroenterology and Quantitative Health Sciences and the Cleveland Clinic Lerner College of Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio
    • Department of Gastroenterology-A31, the Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195
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Abstract

Background:

There has been an increase in the number of studies on the interaction of African American race and the natural history of inflammatory bowel disease (IBD). However, the results from these studies have been conflicting. We aimed to characterize the natural history of ulcerative colitis (UC) in a cohort of African American patients compared with Caucasian controls.

Methods:

We performed a retrospective chart review of patients with UC who were seen in our IBD Center from 2000 to 2010. In all, 102 African American patients and 209 Caucasian patients were included. We assessed clinical variables related to the natural history of UC as well as outcome variables that reflected disease severity.

Results:

African American patients had a shorter median duration (8.0, interquartile range [IQR] = 4.0, 14.0) of UC than Caucasians (10.0, IQR = 6.0, 18.0) (P = 0.006). African American disease patients had more distal disease than controls. African Americans were significantly less likely to use corticosteroids (74.2% vs. 88.8%, P = 0.002), or use immunomodulators (25.8% vs. 69.7%, P < 0.001) than Caucasians. Adjusted multivariate analysis showed that ethnicity was not a risk factor for colectomy (hazard ratio [HR] = 1.6; 95% confidence interval [CI]: 0.78, 3.3).

Conclusions:

There appear to be differences in the natural history of UC in our African American patients when compared with Caucasian controls, while ethnicity was not shown to be a risk factor for colectomy. (Inflamm Bowel Dis 2011;)

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