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Effects of race on treatment and outcomes of inflammatory bowel disease.

Christie L. Mannino, Jessica L. Sterling, Andrew R. Conn, Thomas A. Judge, Yize R. Wang*

Objectives: Prior studies suggested that African American (AA) patients with inflammatory bowel disease (IBD) have worse outcomes compared to non-Hispanic white (NHW) patients. We aimed to compare racial differences in IBD treatment, medication compliance, and clinical remission at our institution. Methods: Chart review was performed on all gastroenterologist visits with the diagnosis of IBD between 01/2011 and 10/2012. Patient characteristics, IBD medical treatment, medication compliance, and clinical remission status were obtained at the last visit. The chi-square (or Fisher’s exact) test and multivariate logistic regression were used in statistical analysis. Results: There was no significant difference in IBD medical treatment between the 87 AA (49 Crohn’s, 38 UC) and 404 NHW patients (182 Crohn’s, 222 UC). Compared to NHW patients, AAs were more likely to use narcotics (16.1% vs 8.4%, p<0.05) and less likely to be compliant with medical treatment (83.9% vs 92.8%) and in clinical remission (12.6% vs 29.2%) (both p<0.05). In multivariate logistic regressions, AA race (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.20-0.80) were negative associated with medication compliance; AA race (OR 0.33, 95% CI 0.17-0.65) and family history of IBD (OR 0.30, 95% CI 0.13-0.73) were negatively associated with clinical remission. Conclusion: Compared with NHW patients, AAs had similar IBD medical treatment, were more likely to use narcotics, and were less likely to be compliant with medical treatment and achieve clinical remission.