Sarcoidosis in Black Women in the United States

Cozier, Yvette C.; Berman, Jeffrey S.; Palmer, Julie R.; Boggs, Deborah A.; Serlin, David M.; Rosenberg, Lynn

doi:10.1378/chest.10-0413

Cited by 152 publications

(66 citation statements)

References 38 publications

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“…Therefore, a diagnosis of sarcoidosis for the purpose of the present study relied on participant self-report. As previously described, an examination of a subset of these self-diagnoses confirmed the diagnosis in 96% of cases 13 . However, it is possible that some study participants had undiagnosed sarcoidosis and that others were mis-diagnosed, which could have affected our mortality estimates.…”

Section: Discussionsupporting

confidence: 71%

“…The Black Women’s Health Study (BWHS) is a prospective cohort study of 59,000 U.S. black women which began in 1995. The prevalence of sarcoidosis in this cohort as of the end of 2009 was estimated to be 2%, and the annual incidence was 71/100,000 13 . The size and prospective nature of the BWHS, including follow-up for death, provide a unique opportunity to investigate all-cause and disease-specific mortality among black women with sarcoidosis.…”

Section: Introductionmentioning

confidence: 82%

“…The BWHS is a prospective cohort study that enrolled 59,000 African-American women aged 21 through 69 years at baseline in 1995 13 . The cohort is followed biennially by postal health questionnaire.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnosis of sarcoidosis was ascertained by self-report 13 . Women who reported sarcoidosis were asked for permission to contact their physicians for information on diagnosis and treatment.…”

Section: Methodsmentioning

confidence: 99%

“…Women who reported sarcoidosis were asked for permission to contact their physicians for information on diagnosis and treatment. Because of the high level of confirmation (96% of the 148 cases for whom physician data were obtained) 13 , all self-reported cases have been included in the present analysis except those disconfirmed by medical records.…”

Section: Methodsmentioning

confidence: 99%

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Mortality Among African American Women With Sarcoidosis: Data From The Black Women's Health Study

Tukey¹,

Berman

Boggs

et al. 2012

C103. Pathogenesis, Biomarkers, and Risk Factors for Interstitial Lung Disease: From Bench to Bedside

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Rationale Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology that disproportionately affects black females. Few studies have specifically addressed causes of death in this population. Objectives To assess rates and causes of death among women with sarcoidosis in a prospective cohort study of U.S. black women. Methods The Black Women’s Health Study is a follow-up study of 59,000 U.S. black women aged 21–69 (median age 38) at entry in 1995. Data on demographic and lifestyle factors and medical conditions, including sarcoidosis, were obtained through biennial questionnaires. Deaths and causes of death from 1995 through 2009 among study subjects were identified from National Death Index data. Measurements We assessed mortality rates among women with and without a history of sarcoidosis. Poisson regression models were used to estimate age-adjusted mortality rates. Cox proportional-hazards models were used to estimate hazard ratios for mortality and 95% confidence intervals (95% CI). Main Results A total of 121 deaths occurred among 1,192 women with a history of sarcoidosis and 2813 deaths among women without the diagnosis. Mortality was greater at every age among women with sarcoidosis and the overall multivariable-adjusted hazard ratio was 2.44 (95% CI 2.03–2.93, p<0.0001). Of the deaths among women with sarcoidosis, 24.7% were directly attributable to sarcoidosis. Conclusions In the Black Women’s Health Study, women with sarcoidosis were more than twice as likely to die as women without the disease, with many of the deaths directly attributable to sarcoidosis. Sarcoidosis is an important cause of premature death among black women with the disease.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Mortality Among African American Women With Sarcoidosis: Data From The Black Women's Health Study

Tukey¹,

Berman

Boggs

et al. 2012

C103. Pathogenesis, Biomarkers, and Risk Factors for Interstitial Lung Disease: From Bench to Bedside

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Diagnosis and Treatment of Pulmonary Sarcoidosis

Belperio

Shaikh

Abtin

et al. 2022

JAMA

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ImportanceSarcoidosis is an inflammatory granulomatous disease of unknown cause that affects an estimated 2 to 160 people per 100 000 worldwide and can involve virtually any organ. Approximately 10% to 30% of patients with sarcoidosis develop progressive pulmonary disease.ObservationAmong patients with pulmonary sarcoidosis, the rate of spontaneous remission without serious sequelae ranges from 10% to 82%. However, lung disease progression occurs in more than 10% of patients and can result in fibrocystic architectural distortion of the lung, which is associated with a mortality rate of 12% to 18% within 5 years. Overall, the mortality rate for sarcoidosis is approximately 7% within a 5-year follow-up period. Worldwide, more than 60% of deaths from sarcoidosis are due to pulmonary involvement; however, more than 70% of deaths from sarcoidosis are due to cardiac involvement in Japan. Up to 70% of patients with advanced pulmonary sarcoidosis develop precapillary pulmonary hypertension, which is associated with a 5-year mortality rate of approximately 40%. Patients with sarcoidosis and precapillary pulmonary hypertension should be treated with therapies such as phosphodiesterase inhibitors and prostacyclin analogues. Although optimal doses of oral glucocorticoids for pulmonary sarcoidosis are unknown, oral prednisone typically starting at a dose of 20 mg/d to 40 mg/d for 2 to 6 weeks is recommended for patients who are symptomatic (cough, dyspnea, and chest pain) and have parenchymal infiltrates and abnormal pulmonary function test results. Oral glucocorticoids can be tapered over 6 to 18 months if symptoms, pulmonary function test results, and radiographs improve. Prolonged use of oral glucocorticoids may be required to control symptoms and stabilize disease. Patients without adequate improvement while receiving a dose of prednisone of 10 mg/d or greater or those with adverse effects due to glucocorticoids may be prescribed immunosuppressive agents, such as methotrexate, azathioprine, or an anti–tumor necrosis factor medication, either alone or with glucocorticoids combined with appropriate microbial prophylaxis for Pneumocystis jiroveci and herpes zoster. Effective treatments are not available for advanced fibrocystic pulmonary disease.Conclusions and RelevanceSarcoidosis has a mortality rate of approximately 7% within a 5-year follow-up period. More than 10% of patients with pulmonary sarcoidosis develop progressive disease and more than 60% of deaths are due to advanced pulmonary sarcoidosis. Oral glucocorticoids with or without another immunosuppressive agent are the first-line therapy for symptomatic patients with abnormal pulmonary function test results and lung infiltrates. Patients with sarcoidosis and precapillary pulmonary hypertension should be treated with therapies such as phosphodiesterase inhibitors and prostacyclin analogues.

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Demystifying Neurosarcoidosis and Informing Prognosis

Gelfand

2017

JAMA Neurol

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Sarcoidosis in Black Women in the United States

Cited by 152 publications

References 38 publications

Mortality Among African American Women With Sarcoidosis: Data From The Black Women's Health Study

Mortality Among African American Women With Sarcoidosis: Data From The Black Women's Health Study

Diagnosis and Treatment of Pulmonary Sarcoidosis

Demystifying Neurosarcoidosis and Informing Prognosis

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