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IBD is Milder, With Later Onset, in Non-US Born Patients
TOPLINE:
Inflammatory bowel disease (IBD) phenotype varies by race, but regardless of race, individuals born outside the United States develop IBD at later ages and have less aggressive disease, new data showed.
METHODOLOGY:
- Researchers reviewed the charts of 525 patients with IBD at a tertiary-care safety-net hospital in New York City from 1997 to 2017.
- Using logistic regression modeling, they compared disease characteristics, treatment, and outcomes by race (White, Black, Hispanic, and Asian races), and immigration status (US-born vs foreign-born).
TAKEAWAY:
- Compared with White patients, Asian patients were more likely to be men (odds ratio [OR], 2.63), whereas Black patients were more likely to have Crohn’s disease (OR, 1.75) and to undergo IBD-related surgery (OR, 2.49).
- Compared with US-born patients, foreign-born patients were more likely to have ulcerative colitis vs Crohn's disease (OR, 1.77).
- Foreign-born patients were also less likely to be diagnosed before the age of 16 years (OR, 0.39), to use biologics (OR, 0.43), to have IBD surgery (OR, 0.39), or to have skin manifestations of the disease (OR, 0.12).
IN PRACTICE:
"Further studies to mechanistically understand the reason for differential IBD risk and presentation in certain races and among immigrant patients may provide new insights into IBD pathogenesis. This can in turn help guide disease prognostication and management in a growing and diversifying IBD patient population," the researchers wrote.
SOURCE:
The study, with first author Ali Khalessi, MD, NYU School of Medicine, New York, was published online on December 16, 2023, in Gastro Hep Advances.
LIMITATIONS:
Documentation of race in medical records could have been inaccurate. The impact of immigration on IBD phenotype may have been underestimated due to the small number of foreign-born patients who immigrated from developed countries with established IBD risk. It was not possible to assess differences in phenotype based on length of residence in the United States.
DISCLOSURES:
Funding for the study was provided by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. The authors declared no conflicts of interest.
