There is a lack of knowledge about why children from racial and ethnic minorities in the United States are more likely to experience health care disparities due to pediatric Crohn’s disease (PCD). From 2007 to 2015, the database of the Texas Children’s Hospital’s ImproveCareNow system was examined retrospectively. Patients with CD who had at least a 2-year follow-up were considered if their symptoms could be traced back to inflammatory bowel disease (IBD). The researcher’s primary objective was to determine whether or not differences existed in diagnostic lag, presentation, treatment, and outcomes at 2 years based on race and ethnicity. Investigators further compared the correlations between these factors and early versus late diagnosis (i.e., over 6 months from disease onset), controlling for race/ethnicity. Patients with PCD totaled 166; 57.8% were non-Hispanic White (NH-White), 18.1% were African American (AA), and 15.7% were Hispanic. Hispanic patients were older than NH-White patients at diagnosis (P=0.0164), and Hispanic patients were diagnosed sooner (P<0.01). Lower rates of granuloma identification were seen in AA patients (33%, P<0.01) and Hispanic patients (35%, P<0.05) compared to NH-White patients (63%). About 2-year steroid-free remission (SFR) rates were significantly lower in AA patients compared to NH-White patients (P<0.05). An earlier diagnosis was connected to both a higher ESR and a lower hemoglobin level (P<0.01). Increased rates of surgery within 2 years of diagnosis were seen in cases where the diagnosis was made early (P<0.05). SFR at 2 years was negatively correlated with diagnostic fecal calprotectin levels (P<0.05). A significant positive correlation (P<0.05) was found between early use of biologics with 2-year SFR, whereas a significant negative correlation was seen between early use of corticosteroids and 2-year SFR. PCD may be more difficult to diagnose, treat, and manage if the patient is of a certain race or ethnicity. This acknowledgment provides a starting point for implementing equitable PCD treatment.
Source – journals.lww.com/jpgn/Abstract/2022/09000/Racial_and_Ethnic_Variation_in_Presentation,.18.aspx
