Hispanic Ethnicity is Associated with Milder Disease Severity in Crohn’s Disease but not Ulcerative Colitis

Christie Choi, Amit Singal, Kunjali Padhya, Avegail Flores, Ezra Burstein and Tasneem Ahmed*

Received:March 08, 2019;   Published: March 19, 2019

DOI: 10.32474/CTGH.2018.01.000132

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Abstract

Background: The incidence of inflammatory bowel disease (IBD) is rising among minority patients; however, few studies have examined racial/ethnic disparities in epidemiology, disease severity, and treatment course.

Aim: To characterize differences in IBD disease severity and outcomes among IBD patients from minority communities.

Methods: A cohort of adult patients with IBD was followed from January 2007- December 2012 in a large urban safety-net hospital. Fisher exact and Mann-Whitney rank sum tests were used to compare disease phenotype, severity, need for anti-TNF therapy, receipt of IBD-related surgery, and hospitalizations.

Results: We identified 291 adult IBD patients; 148 with Crohn’s Disease (CD), 143 with ulcerative colitis (UC). Our cohort was racially diverse with 32% Caucasian, 37% Black, 28% Hispanic, and 2% Asian. 54% were male and the median age of the cohort was 44 years. Hispanic patients had a more benign disease course characterized by less IBD-related surgeries (mean 0.4 vs. 1.1, p=0.001), less hospitalizations (mean 2.1 vs. 2.9, p=0.04), and lower need for anti-TNF therapy (27% vs. 39%, p=0.05) when compared to non-Hispanic patients. On subgroup analysis, these differences were noted particularly among those with CD but not UC. Hispanic UC patients had a similar number of IBD-related surgeries (p=0.16) and hospitalizations (p=0.62), whereas Hispanic CD patients had less IBD-related surgeries (mean 0.8 vs. 1.8, p=0.01), less hospitalizations (mean 2.4 vs. 3.8, p=0.05), and lower need for anti-TNF (38% vs. 57%, p=0.09).

Conclusion: Hispanic ethnicity is associated with lower disease severity in CD but not associated with disease severity in UC.

Keywords:Inflammatory Bowel Disease; Crohn’s Disease; Ulcerative Colitis; Race; Ethnicity; Disparities

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