Department of Medicine, Division of Internal Medicine, University of Florida, Gainesville, Florida, USA.
Department of Medicine, Division of Digestive Diseases, Emory University, Atlanta, Georgia, USA.
Clin Transl Gastroenterol. 2024 Aug 1;15(8):e00737. doi: 10.14309/ctg.0000000000000737.
Crohn's disease and ulcerative colitis are characterized by chronic inflammation of the gastrointestinal tract. Mucosal healing (MH) is a therapeutic goal in patients with inflammatory bowel disease (IBD). Current data suggest that Black patients may experience worse clinical outcomes than White patients with IBD. This study assessed MH between Black and White patients with IBD.
Retrospective analysis was performed on Black and White adults with IBD who were hospitalized for an active flare. The presence of MH was assessed at 6-18 months after hospitalization. IBD treatments received before and during hospitalization, within 6 months, and 6-18 months after discharge were recorded. C-reactive protein (CRP) levels were collected at hospitalization and 6-18 months after discharge; the difference was reported as delta CRP.
One hundred nine patients were followed up after hospitalization. Of those 88 (80.7%) were White patients, and 21 (19.3%) were Black patients. White and Black patients received similar proportions of IBD treatment before ( P = 0.2) and during ( P = 0.6) hospitalization, within 6 months ( P = 0.1), and 6-18 months ( P = 0.1) after discharge. Black patients achieved numerically higher rates of MH (15/21 = 71.4% vs 53/88 = 60.2%, P = 0.3) and delta CRP ( P = 0.2) than White patients, however, not statistically significant.
In patients admitted to the hospital with an IBD flare with similar treatment and care, there was a trend toward higher rates of MH in Black patients compared with White patients. These data suggest that MH is likely not the only factor that is associated with Black patients experiencing worse clinical outcomes when compared with White patients.
克罗恩病和溃疡性结肠炎的特征是胃肠道的慢性炎症。黏膜愈合(MH)是炎症性肠病(IBD)患者的治疗目标。目前的数据表明,与 IBD 患者相比,黑人患者的临床结局可能更差。本研究评估了 IBD 黑人患者与白人患者的 MH 情况。
对因活动期发作而住院的 IBD 黑人和白人成年人进行回顾性分析。在住院后 6-18 个月评估 MH 的存在情况。记录住院前和住院期间、住院后 6 个月内和 6-18 个月内接受的 IBD 治疗。收集住院时和出院后 6-18 个月的 C 反应蛋白(CRP)水平;报告差异作为 delta CRP。
有 109 例患者在出院后得到了随访。其中 88 例(80.7%)为白人患者,21 例(19.3%)为黑人患者。白人患者和黑人患者在住院前(P = 0.2)和住院期间(P = 0.6)、住院后 6 个月内(P = 0.1)和 6-18 个月内(P = 0.1)接受的 IBD 治疗比例相似。黑人患者实现 MH 的比例(15/21 = 71.4% vs 53/88 = 60.2%,P = 0.3)和 delta CRP 数值较高(P = 0.2),但无统计学意义。
在因 IBD 发作而住院并接受相似治疗和护理的患者中,与白人患者相比,黑人患者 MH 的比例更高,这一趋势具有统计学意义。这些数据表明,MH 可能不是导致黑人患者的临床结局比白人患者更差的唯一因素。