The impact of demographic disparities in the presentation of sarcoidosis: A multicenter prospective study,Respiratory Medicine

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The impact of demographic disparities in the presentation of sarcoidosis: A multicenter prospective study
Respiratory Medicine ( IF 4.3 ) Pub Date : 2021-08-09 , DOI: 10.1016/j.rmed.2021.106564
Ying Zhou ₁ , Alicia K Gerke ₂ , Elyse E Lower ₃ , Alexander Vizel ₄ , Deepak Talwar ₅ , Irina Strambu ₆ , Joel Francesqui ₇ , Jacobo Sellares ₇ , Michiru Sawahata ₈ , Ogugua Ndili Obi ₉ , Sonoko Nagai ₁₀ , Kiminobu Tanizawa ₁₁ , Marc A Judson ₁₂ , Florence Jeny ₁₃ , Dominique Valeyre ₁₃ , Marina Dornfeld Cunha Castro ₁₄ , Carlos Pereira ₁₄ , Meyer Balter ₁₅ , Robert P Baughman ₃

Affiliation

Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China.
Department of Internal Medicine, Pulmonary and Critical Care, University of Iowa, 200 Hawkins Dr, Iowa City, IA, 52246, USA.
Internal Medicine, University of Cincinnati, University of Cincinnati Medical Center, Cincinnati, OH, 45267-0565, USA.
Kazan State Medical University, Department of Phthisiopulmonology. Butlerov Str., 49. Kazan, Tatarsan Republic. 420012, Russian Federation.
Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India.
Pulmonology Department, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Kyoto Central Clinic, Clinical Research Center, Kyoto, Japan.
Kyoto Central Clinic, Clinical Research Center, Kyoto, Japan; Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Medicine, Albany Medical College, Albany, NY, USA.
Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France.
Department of Medicine, Division of Respiratory Diseases, Interstitial Lung Diseases Center, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Division of Respirology, Dept of Medicine, Mount Sinai Hospital, Toronto, ON, Canada.

Objective

To study how demographic differences impact disease manifestation of sarcoidosis using the WASOG tool in a large multicentric study.

Methods

Clinical data regarding 1445 patients with sarcoidosis from 14 clinical sites in 10 countries were prospectively reviewed from Feb 1, 2020 to Sep 30, 2020. Organ involvement was evaluated for the whole group and for subgroups differentiated by sex, race, and age.

Results

The median age of the patients at diagnosis was 46 years old; 60.8% of the patients were female. The most commonly involved organ was lung (96%), followed by skin (24%) and eye (22%). Black patients had more multiple organ involvement than White patients (OR = 3.227, 95% CI: 2.243–4.643) and females had more multiple organ involvement than males (OR = 1.238, 95% CI: 1.083–1.415). Black patients had more frequent involvement of neurologic, skin, eye, extra thoracic lymph node, liver and spleen than White and Asian patients. Women were more likely to have eye (OR = 1.522, 95%CI: 1.259–1.838) or skin involvement (OR = 1.369, 95%CI: 1.152–1.628). Men were more likely to have cardiac involvement (OR = 1.326, 95%CI: 1.096–1.605). A total of 262 (18.1%) patients did not receive systemic treatment for sarcoidosis. Therapy was more common in Black patients than in other races.

Conclusion

The initial presentation and treatment of sarcoidosis was related to sex, race, and age. Black and female individuals are found to have multiple organ involvement more frequently. Age at diagnosis<45, Black patients and multiple organ involvement were independent predictors of treatment.

中文翻译：

人口统计学差异对结节病表现的影响：一项多中心前瞻性研究

客观的

在一项大型多中心研究中使用 WASOG 工具研究人口统计学差异如何影响结节病的疾病表现。

方法

前瞻性回顾了 2020 年 2 月 1 日至 2020 年 9 月 30 日期间来自 10 个国家 14 个临床中心的 1445 名结节病患者的临床数据。评估了整个组和按性别、种族和年龄区分的亚组的器官受累情况。

结果

诊断时患者的中位年龄为 46 岁；60.8%的患者为女性。最常受累的器官是肺 (96%)，其次是皮肤 (24%) 和眼睛 (22%)。黑人患者多器官受累多于白人患者 (OR = 3.227, 95% CI: 2.243–4.643)，女性多器官受累多于男性 (OR = 1.238, 95% CI: 1.083–1.415)。与白人和亚裔患者相比，黑人患者的神经系统、皮肤、眼睛、胸外淋巴结、肝脏和脾脏受累的频率更高。女性更可能有眼睛 (OR = 1.522, 95%CI: 1.259–1.838) 或皮肤受累 (OR = 1.369, 95%CI: 1.152–1.628)。男性更可能有心脏受累 (OR = 1.326, 95%CI: 1.096–1.605)。共有 262 名 (18.1%) 患者未接受结节病的全身治疗。