P2585 - Racial Disparities in Clinical Manifestation of Crohn’s disease

Raguraj Chandradevan, MBBS¹, Bobak Moazzami, MD², Jaron Longo, MS³, Chakravarthy Nulu, MS¹, Martin Chu, MS¹, Brandon Garten, BS¹, Gaurav Gopu, ⁴, Aisha Naushad, MS¹, Catarina Cutter, BS⁵, Michael Temple, MD¹, Sandeep Yerraguntla, ¹, Humberto Sifuentes, MD^5
1Medical College of Georgia at Augusta University, Augusta, GA; ²Northside Hospital Gwinnett, Atlanta, GA; ³Augusta University, North Augusta, SC; ⁴Medical College of Georgia at Augusta University, Cumming, GA; ⁵Augusta University, Augusta, GA

Introduction: African Americans (AA) have been underrepresented in clinical studies of Crohn’s Disease (CD). This study aims to evaluate and compare the clinical manifestations and disease progression of CD in AA and Caucasians (CC).

Methods: We conducted a single-center cross-sectional study of all patients with CD, both hospitalized and outpatient, treated from 2019 to 2024. Chart reviews were used to identify disease location, peri rectal disease, strictures, penetrating natures, endoscopy and surgical history, extra intestinal manifestation, demographics, treatment and medication use. Patients with ulcerative colitis or indeterminant colitis were excluded.

Results: A total of 167 patients were identified, comprising 43% AA and 56% CC. Mean age of diagnosis was 43±14.56 for AA and 47±15.71 for CC. The average measured BMI was higher in AA (28.55±8.07) than CC (26.01±5.93) (p< 0.005; Table 1). Although there was no significant gender difference in the overall diagnosis of CD, a higher prevalence was observed among females in AA (F/M ratio: 43/27 in AA vs. 50/45 in CC). CDs related surgeries occurred in 71% of AA and 56% of CC. Time from diagnosis to surgery was 17 years for AA and 15 years for CC with a wide range of standard deviation. No significance differences noted in extra intestinal manifestations, undergoing surgeries, treatment modalities, insurances and perianal disease. AA were more likely to have penetrating phenotype (B3) and less likely to have inflammatory (B1) and stricturing phenotypes (B2) as compared to whites (p< 0.004; Table 1). Multivariate logistic regression analysis revealed that the odds of having a B3 phenotype compared to a B1 phenotype were approximately 3.08 times higher for AA compared to CC (CI: 1.33-7.13) after adjusting for age, sex and BMI. In a subgroup analysis of those with the B3 phenotype, AA were less likely to use steroids compared to CC (32% Vs 53%, p < 0.05).

Discussion: This study showed that AA were more likely to develop complicated CD over time compared to CC. Higher BMI was noted among AA, however not correlated with complicated CD. AA were diagnosed younger, had a female predominance, longer time from diagnosis to surgery and underwent more surgeries. These findings suggest that CD may manifest differently in AA, though socioeconomic status, healthcare access, and awareness of the disease process may also play a role.


Disclosures:


Raguraj Chandradevan, MBBS¹, Bobak Moazzami, MD², Jaron Longo, MS³, Chakravarthy Nulu, MS¹, Martin Chu, MS¹, Brandon Garten, BS¹, Gaurav Gopu, ⁴, Aisha Naushad, MS¹, Catarina Cutter, BS⁵, Michael Temple, MD¹, Sandeep Yerraguntla, ¹, Humberto Sifuentes, MD⁵. P2585 - Racial Disparities in Clinical Manifestation of Crohn’s disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.