A Prospective Observational Study of Disease Severity and Mortality in Hispanic American Patients With Systemic Sclerosis

Abstract

Objectiveto characterize disease manifestations in Hispanic American patients with systemic sclerosis (SSc) in comparison to non‐Hispanic White and Black patients.MethodsLongitudinal clinical characteristics were collected prospectively in the Genetics versus Environment in Scleroderma Outcome Study (GENISOS) cohort. All patients fulfilled the Classification Criteria for SSc and had a disease duration less than five years at enrollment.Results427 patients, consisting of 124 Hispanic, 220 non‐Hispanic White, and 83 non‐Hispanic Black participants were examined. At enrollment, Hispanic patients were significantly younger but had longer disease duration, higher frequency of U1‐RNP positivity as well as concurrent systemic lupus erythematosus (SLE) diagnosis, and lower income and educational levels in comparison to non‐Hispanic White patients. Compared to non‐Hispanic Black Americans, Hispanic patients had more frequently limited cutaneous involvement and anti‐centromere antibodies.In the longitudinal analysis, Hispanic patients had significantly lower forced vital capacity % predicted (point estimate=‐9.3%, p<0.001) than non‐Hispanic White but not Black patients. Hispanic patients had similar longitudinal modified Rodnan Skin Scores (mRSS) like non‐Hispanic Whites but lower measurements than non‐Hispanic Black patients (point estimate = ‐3.2, p=0.029). Hispanic patients had significantly higher serially obtained perceived functional disability scores than White patients (point estimate=0.29, p<0.001). Hispanic patients also had higher mortality than White Americans even after adjustment for age, gender, and socioeconomic status.ConclusionHispanic patients have higher likelihood of having U1‐RNP positivity and SLE overlap, more severe restrictive lung disease, as well as higher rate of mortality than non‐Hispanic White patients.