Mucosal Healing Among Black and White Patients With Inflammatory Bowel Disease

• Published in: Clinical and translational gastroenterology Vol. 15; no. 8; p. e00737
• Main Authors: Dixit, Devika, Ruiz, Nicole C, Shen, Steve, Daneshmand, Arvin, Rodriguez, Vanessa I, Qian, Steve, Neal, Dan, Rampertab, S Devi, Zimmermann, Ellen M, Kamel, Amir Y
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01-08-2024; Wolters Kluwer
• Subjects: Adult; Biological products; Black or African American; C-Reactive Protein - analysis; Clinical outcomes; Colitis, Ulcerative - ethnology; Colitis, Ulcerative - therapy; Combination therapy; Crohn Disease - ethnology; Crohn Disease - therapy; Crohns disease; Demographics; Electronic health records; Endoscopy; Female; Health care access; Health disparities; Histology; Hospitalization; Hospitalization - statistics & numerical data; Humans; Immunomodulators; Inequality; Inflammation; Inflammatory Bowel Disease; Inflammatory Bowel Diseases - ethnology; Inflammatory Bowel Diseases - therapy; Intestinal Mucosa - pathology; Magnetic resonance imaging; Male; Medical records; Middle Aged; Patients; Race; Racial differences; Retrospective Studies; Steroids; White; Wound Healing; Young Adult
• ISSN: 2155-384X; 2155-384X
• DOI: 10.14309/ctg.0000000000000737

Crohn's disease and ulcerative colitis are characterized by chronic inflammation of the gastrointestinal tract. Mucosal healing (MH) is a therapeutic goal in patients with inflammatory bowel disease (IBD). Current data suggest that Black patients may experience worse clinical outcomes than White patients with IBD. This study assessed MH between Black and White patients with IBD.
Retrospective analysis was performed on Black and White adults with IBD who were hospitalized for an active flare. The presence of MH was assessed at 6-18 months after hospitalization. IBD treatments received before and during hospitalization, within 6 months, and 6-18 months after discharge were recorded. C-reactive protein (CRP) levels were collected at hospitalization and 6-18 months after discharge; the difference was reported as delta CRP.
One hundred nine patients were followed up after hospitalization. Of those 88 (80.7%) were White patients, and 21 (19.3%) were Black patients. White and Black patients received similar proportions of IBD treatment before ( P = 0.2) and during ( P = 0.6) hospitalization, within 6 months ( P = 0.1), and 6-18 months ( P = 0.1) after discharge. Black patients achieved numerically higher rates of MH (15/21 = 71.4% vs 53/88 = 60.2%, P = 0.3) and delta CRP ( P = 0.2) than White patients, however, not statistically significant.
In patients admitted to the hospital with an IBD flare with similar treatment and care, there was a trend toward higher rates of MH in Black patients compared with White patients. These data suggest that MH is likely not the only factor that is associated with Black patients experiencing worse clinical outcomes when compared with White patients.