Black Inflammatory Bowel Disease Patients Have Lower Response to Antitumor Necrosis Factor Agents Compared With White Patients

Burstiner, Landen; Owings, Anna H.; Royer, Amor; Hreish, Yousef; Johnson, Jeshanah; Barr, Madelyn; Laird, Hannah; Tarugu, Spurthi; Edwards, Kane; Bradley, Lauren E.; Brar, Himmat; Robinson, Tanya O.; Hosseini‐Carroll, Pegah; Liu, Julia; Glover, Sarah C.

doi:10.1093/ibd/izad005

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Furthermore, recent evidence suggests that treatment with anti-TNF agents has a significantly lower therapeutic response among non-Hispanic Black patients with IBD than among non-Hispanic White patients, which may be due to the underrepresentation of racial/ethnic diversity in clinical trials. 38 As anti-TNFs are the standard first-line treatment for many patients with moderate or severe IBD, the difference in therapeutic response may partially contribute not only to deferred healthcare access, but also to potential distrust of the healthcare system should concerns regarding lack of treatment effectiveness be dismissed. As such, as evidenced in this study, non-Hispanic Black participants may face financial barriers to healthcare access which prevent them from using primary and/or preventative care for their condition, instead turning to emergency care when their symptoms cannot be otherwise managed.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Health-Related Outcomes in Crohn’s Disease: Results From the National Health and Wellness Survey

Burbage,

Krupsky,

Cambron-Mellott

et al. 2024

Crohn's &Amp; Colitis 360

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Background Crohn’s disease (CD) is a chronic inflammatory condition affecting the entire gastrointestinal tract that is associated with significant humanistic, clinical, and economic burden. Few studies have assessed the association between CD severity and patient-reported outcomes (PROs), healthcare resource utilization (HCRU), and medical costs; even fewer have examined differences in disease outcomes among patients of various racial/ethnic groups. Methods In this cross-sectional study, sociodemographic data, PROs, and economic outcomes for participants with self-reported CD were collected from the National Health and Wellness Survey (2018-2020). Multivariable analyses were used to assess the association of CD severity and race/ethnicity with health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), HCRU, and medical costs. Results Analyses included 1,077 participants with CD (818 non-Hispanic White, 109 non-Hispanic Black, and 150 Hispanic). Participants with self-reported moderate/severe CD reported significantly worse HRQoL and WPAI, greater HCRU, and higher medical costs than those with self-reported mild CD. Non-Hispanic Black participants reported better HRQoL and fewer healthcare provider visits than non-Hispanic White participants. There were no significant differences in PROs between non-Hispanic White and Hispanic groups. Interactions between race/ethnicity and CD severity emerged for some, but not all groups: specifically, non-Hispanic Black participants with moderate/severe CD reported greater absenteeism and more gastroenterologist visits than non-Hispanic Black participants with mild CD. Conclusions Participants with moderate/severe CD reported worse PROs, greater HCRU, and higher medical costs than those with mild CD. Additionally, racial/ethnic differences were found across several HCRU and economic outcomes. Further research is needed to better understand factors contributing to burden among patients with varying CD severity across racial/ethnic groups.

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Health-Related Outcomes in Crohn’s Disease: Results From the National Health and Wellness Survey

Burbage,

Krupsky,

Cambron-Mellott

et al. 2024

Crohn's &Amp; Colitis 360

View full text Add to dashboard Cite

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Factors Associated with Delays in Initiating Biologic Therapy in Patients with Inflammatory Bowel Disease

Abadir,

Troia,

Said

et al. 2024

Dig Dis Sci

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Black Race is Associated with Decreased Exposure to Advanced Therapies and Worse Outcomes in Individuals with Ulcerative Colitis

McFalls,

Chaaban,

Melia

2024

Aliment Pharmacol Ther

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BackgroundFor people diagnosed with ulcerative colitis (UC), racial disparities exist both in access to medications and clinical outcomes.MethodsWe used the TriNetX database for two population‐based retrospective analyses with Black (n = 22,519) and Asian (n = 8,626) individuals with UC matched for age, sex, and ethnicity. Outcomes included mortality, medication prescriptions, and clinical encounters at 6 months and 10 years.ResultsAt 6 months and 10 years after diagnosis, Black people had increased mortality (2.7% vs. 1.9% and 8.1% vs. 6.9%, p < 0.0001), were prescribed fewer UC‐specific therapies (21.3% vs. 26.4% and 30% vs. 36%, p < 0.0001), had higher rates of emergency department visits (22.3% vs. 13.6% and 41.2% vs. 31.5%, p < 0.0001), and higher hospitalisation rates (30.1% vs. 25.8% and 42.6% vs. 39.9%, p < 0.0001). At 6 months, they had more opioid prescriptions (18.5% vs. 15.7%, p < 0.0001). Asian people had lower mortality at 10 years (5.6% vs. 7.7%, p < 0.0001), higher rates of UC‐specific medications at 6 months (28.6% vs. 26.5%, p = 0.002), and more hospitalizations (38.8% vs. 27.7%, p < 0.0001 at 6 months and 50% vs. 42.2%, p < 0.0001 at 10 years).ConclusionBlack individuals with UC are prescribed fewer disease‐specific therapies compared to White individuals and have increased hospitalizations and mortality. Black individuals have higher rates of opioid prescriptions. Opioids have been associated with increased complication rates in inflammatory bowel disease. These trends are not seen in Asian individuals. This reveals critical disparities in the care of Black people with UC with opportunity for targeted interventions.

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Black Inflammatory Bowel Disease Patients Have Lower Response to Antitumor Necrosis Factor Agents Compared With White Patients

Cited by 3 publications

References 19 publications

Racial and Ethnic Disparities in Health-Related Outcomes in Crohn’s Disease: Results From the National Health and Wellness Survey

Racial and Ethnic Disparities in Health-Related Outcomes in Crohn’s Disease: Results From the National Health and Wellness Survey

Factors Associated with Delays in Initiating Biologic Therapy in Patients with Inflammatory Bowel Disease

Black Race is Associated with Decreased Exposure to Advanced Therapies and Worse Outcomes in Individuals with Ulcerative Colitis

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