TY - JOUR
T1 - A comparison of the risk of postoperative recurrence between African-American and Caucasian patients with Crohn's disease
AU - Anyane-Yeboa, Adjoa
AU - Yamada, Akihiro
AU - Haider, Haider
AU - Wang, Yunwei
AU - Komaki, Yuga
AU - Komaki, Fukiko
AU - Pekow, Joel
AU - Dalal, Sushila
AU - Cohen, Russell D.
AU - Cannon, Lisa
AU - Umanskiy, Konstantin
AU - Smith, Radhika
AU - Hurst, Roger
AU - Hyman, Neil
AU - Rubin, David T.
AU - Sakuraba, Atsushi
N1 - Funding Information:
Declaration of personal interests: AAY, AY, HH, FK, LC, KU, RS, RH, NH; none. YK was supported by the Pediatric Oncology Research Fellowship of the Children's Cancer Association of Japan. JP; research grants from Takeda and Abbvie. SD; investigator initiated research grant from Pfizer. RDC; consultant and/or scientific advisory board for Abbvie, Celgene, Entera Health, Hospira, Janssen, Pfizer, Sandoz Biopharmaceuticals, Takeda, and UCB Pharma. Speaker's bureau for Abbvie, and Takeda. DTR; consultant and grant support from Takeda, Janssen, and AbbVie, consultant for Pfizer and Amgen. AS; speaker for Mitsubishi-Tanabe and consultant for Abbvie. Declaration of funding interests: None.
Funding Information:
Declaration of personal interests: AAY, AY, HH, FK, LC, KU, RS, RH, NH; none. YK was supported by the Pediatric Oncology Research Fellowship of the Children's Cancer Association of Japan. JP; research grants from Takeda and Abbvie. SD; investigator initiated research grant from Pfizer. RDC; consultant and/or scientific advisory board for Abbvie, Celgene, Entera Health, Hospira, Janssen, Pfizer, Sandoz Biopharmaceuticals, Takeda, and UCB Pharma. Speaker's bureau for Abbvie, and Takeda. DTR; consultant and grant support from Takeda, Janssen, and AbbVie, consultant for Pfizer and Amgen. AS; speaker for Mitsubishi‐Tanabe and consultant for Abbvie. Declaration of funding interests: None.
Publisher Copyright:
© 2018 John Wiley & Sons Ltd
PY - 2018/11
Y1 - 2018/11
N2 - Background: Many patients with Crohn's disease will develop complications that require surgery. Recurrence after surgery is common. Aim: To assess racial differences in postoperative recurrence between African-Americans and Caucasians. Methods: Medical records of Crohn's disease patients who underwent surgery (ileal, colonic, or ileocolonic resection) between June 2014 and June 2016 were reviewed. The primary endpoints were clinical and endoscopic remission at 6-12 months after a Crohn's disease surgery. Secondary outcomes included biological and histologic remission. Risks of recurrence were assessed by univariate, multivariate, and propensity score-matched analysis. Results: Thirty-six African-American and 167 Caucasian patients with Crohn's disease were included for analysis. There was no difference in disease location, disease behaviour, type of surgery performed, and pre- or postoperative medication use between the two groups. The rate of endoscopic remission did not differ between African-American and Caucasian patients (50% vs 42%, P = 0.76), and race did not influence the risk of endoscopic recurrence on univariate, multivariate, or propensity score-matched analysis. The rate of clinical remission was significantly lower in African-American patients compared to Caucasian patients (36% vs. 63%, P = 0.008). African-American race was significantly associated with clinical recurrence on univariate (odds ratio (OR) 6.76, 95% CI 1.50-30.40; P = 0.01), multivariate (OR 5.02, 95% CI 1.60-15.80; P = 0.006), and propensity-matched analysis (68% vs. 32% in Caucasians, P = 0.005). Rates of biologic and histologic remission were similar between the two groups on all analyses. Conclusions: We found that African-American patients with Crohn's disease have a similar degree of objective measures of mucosal inflammation after surgery including endoscopic recurrence as compared to Caucasian patients. However, African-American race was significantly associated with clinical recurrence, suggesting the presence of ethnic variation in postoperative presentation in Crohn's disease.
AB - Background: Many patients with Crohn's disease will develop complications that require surgery. Recurrence after surgery is common. Aim: To assess racial differences in postoperative recurrence between African-Americans and Caucasians. Methods: Medical records of Crohn's disease patients who underwent surgery (ileal, colonic, or ileocolonic resection) between June 2014 and June 2016 were reviewed. The primary endpoints were clinical and endoscopic remission at 6-12 months after a Crohn's disease surgery. Secondary outcomes included biological and histologic remission. Risks of recurrence were assessed by univariate, multivariate, and propensity score-matched analysis. Results: Thirty-six African-American and 167 Caucasian patients with Crohn's disease were included for analysis. There was no difference in disease location, disease behaviour, type of surgery performed, and pre- or postoperative medication use between the two groups. The rate of endoscopic remission did not differ between African-American and Caucasian patients (50% vs 42%, P = 0.76), and race did not influence the risk of endoscopic recurrence on univariate, multivariate, or propensity score-matched analysis. The rate of clinical remission was significantly lower in African-American patients compared to Caucasian patients (36% vs. 63%, P = 0.008). African-American race was significantly associated with clinical recurrence on univariate (odds ratio (OR) 6.76, 95% CI 1.50-30.40; P = 0.01), multivariate (OR 5.02, 95% CI 1.60-15.80; P = 0.006), and propensity-matched analysis (68% vs. 32% in Caucasians, P = 0.005). Rates of biologic and histologic remission were similar between the two groups on all analyses. Conclusions: We found that African-American patients with Crohn's disease have a similar degree of objective measures of mucosal inflammation after surgery including endoscopic recurrence as compared to Caucasian patients. However, African-American race was significantly associated with clinical recurrence, suggesting the presence of ethnic variation in postoperative presentation in Crohn's disease.
UR - http://www.scopus.com/inward/record.url?scp=85052639021&partnerID=8YFLogxK
U2 - 10.1111/apt.14951
DO - 10.1111/apt.14951
M3 - Article
C2 - 30126019
AN - SCOPUS:85052639021
VL - 48
SP - 933
EP - 940
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 9
ER -