Researchers on three unrelated projects have published results suggesting that certain traits in patients with Crohn's disease are related to race. Experts predict that their conclusions will aid in the development of personalized treatment for this incurable digestive disease.
Crohn's disease and ulcerative colitis are the two principal types of inflammatory bowel disease (IBD). According to the Crohn's & Colitis Foundation of America, Crohn's affects around 700,000 Americans. It typically strikes between the ages of 15 and 35.
Of racial groups, Caucasians have the highest risk of developing the disorder, says the Mayo Clinic. Those who are Ashkenazi Jews have the greatest chance of contracting the illness. In recent years, however, incidence of Crohn's disease has been increasing among non-Caucasian minority groups, among them African Americans, Medical News Today reports.
The three research groups presented their findings at the Annual Scientific Meeting of the American College of Gastroenterology. Their goal was explaining how racial disparities regarding disease characteristics, the use of infliximab (brand name: Remicade), and the incidence of fistulizing Crohn's disease affect patients and disease management.
University of Chicago scientists noted that African Americans with IBD were more likely than Caucasians to have symptoms outside the intestines, among them joint pain and skin inflammation. Of those with Crohn's disease -- 797 Caucasians and 88 African Americans -- the latter were less likely to have disease in the small intestine. African American Crohn's patients showed no difference in rates of perianal, colonic, jejunal, or upper gastrointestinal disease, however.
In a second study, scientists from the Mount Sinai School of Medicine explored racial differences and observed the prevalence of severe fistulizing perianal disease (FPD) in Crohn's patients treated with infliximab in 2011. Fistulas are a significant complication of the disorder, and as many as a third of Crohn's patients experience perianal disease.
The researchers concluded that African Americans were 1.87 times more likely than Caucasians, Hispanics, or Asians to develop FPD. The risk for Caucasians was significantly less than for the other groups.
Scientists at the University of Maryland School of Medicine studied the use of infliximab in both African Americans and Caucasians. They followed a group of 129,478 IBD patients and determined that African Americans had a 12 percent lower chance of getting this treatment. Among those with moderate-to-severe disease, the rate was 15 percent.
All three studies point to the need for more research on phenotypic differences in Crohn's patients. They also raise hope for treatments tailored to those differences but also cost-effective.
Unfortunately, what works to control symptoms in one patient isn't effective in another. Despite taking the gamut of Crohn's medications, I have had five surgeries, including two for FPD. I received infliximab infusions for two years, but they didn't control the disease. The discovery that certain traits are tied to race in Crohn's disease should lead to more research and improved treatment options.
Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.
