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. 2021 Oct:187:106564.
doi: 10.1016/j.rmed.2021.106564. Epub 2021 Aug 9.

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

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
Affiliations

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

Ying Zhou et al. Respir Med. 2021 Oct.

Abstract

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.

Keywords: Clinical manifestation; Demographic disparities; Organ involvement; Sarcoidosis.

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Conflict of interest statement

Conflict of interest

The authors declared that they have no conflicts of interest to this work.

We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.

Figures

Figure 1.
Figure 1.
Distribution of patients with sarcoidosis by age at diagnosis and sex. The percentage of male and female patients are shown separately.
Figure 2.
Figure 2.
Comparison of organ involvement which was significant difference between groups on basis of race, sex or age.
Figure 3.
Figure 3.
Comparison of organ involvement which was significant difference among continents.
Figure 4A.
Figure 4A.
Percent treated at visit versus site.
Figure 4B.
Figure 4B.
Percent treated at visit versus race and continents.
Figure 5A.
Figure 5A.
Percent treated (current or past) versus site.
Figure 5B.
Figure 5B.
Percent treated (current or past) versus race and continents.
Figure 6.
Figure 6.
Therapy could include one drug or a combination. Drugs prescribed included cytotoxics (methotrexate, azathioprine, leflunomide, mycophenolate or Hydroxychloroquine), biologics (infliximab, Adalimumab or rituximab) and repository corticotropin injection.
See this image and copyright information in PMC

References

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