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Hispanic patients with systemic sclerosis have a higher mortality rate and risk of lupus


February 7, 2024

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Key takeaways:

  • Hispanic SSc patients were also younger at baseline, with longer disease duration, compared with non-Hispanic white patients.
  • Future research could focus on whether U1-RNP positivity is related to human leukocyte antigen types.

According to the data, Hispanic patients with systemic sclerosis are more likely to have concurrent systemic lupus erythematosus and U1-RNP positivity, and face higher mortality rates than non-Hispanic white patients.

“Reports suggest ethnic disparities among patients with SSc, with a possible influence on disease outcomes and survival rates.” Bochra Jandali, MD, from the McGovern School of Medicine at the University of Texas Health Science Center, and colleagues wrote in Arthritis Care and Research.

A graph showing the rate of concurrent SLE in Hispanic patients is 4.1% versus 0.5% in non-Hispanic white patients.

Data derived from Jandali B, et al. Res Arthritis Care. 2024;doi:10.1002/acr.25300.

“Data on the characteristics and prognosis of SSc in Hispanic Americans are scarce,” they added. “…There are no reports of prospective cohort studies focusing on the demographic and clinical characteristics of Hispanic American patients with SSc compared to other ethnic/racial groups.”

To evaluate disease manifestations among Hispanic American patients with SSc, compared with non-Hispanic white and black patients, Jandali and colleagues conducted a longitudinal analysis of data from the prospective observational cohort of the Genetics Versus Environment Outcomes Study in scleroderma (GENISOS). The researchers included data from a total of 427 patients with SSc of less than five years’ duration. Among these patients, 124 (29%) were Hispanic, 220 (51.5%) were non-Hispanic white, and 83 (19.5%) were non-Hispanic black.

At baseline, 14% of Hispanic patients were U1-RNP positive, compared to 4.6% of non-Hispanic white patients (P = 0.003). Meanwhile, SLE was present in 4.1% of Hispanic patients and in one non-Hispanic white patient (P = .023). Hispanic patients were also significantly younger overall, compared with non-Hispanic white patients, at enrollment (mean age 46 vs. 51 years) and demonstrated a longer disease duration (mean duration 2.7 years versus 2.1 years).

According to the researchers, Hispanic patients also had more restrictive lung disease and greater perceived disability compared to non-Hispanic white patients, with significantly lower levels of forced vital capacity (mean difference = –9.3%) and scores significantly higher on the modified Health Assessment. Questionnaire (mean difference = 0.29). During a median follow-up of 3.8 years, Hispanic patients demonstrated a higher risk of death than non-Hispanic white patients, regardless of age and sex (HR = 1.67; P = .015).

Meanwhile, Hispanic patients more frequently demonstrated limited skin disease and anticentromere antibodies compared with non-Hispanic black patients. Additionally, Hispanic patients had lower Rodnan skin scores than non-Hispanic black patients (point estimate = –3.2; P = .029).

Future research should focus on whether the link with U1-RNP positivity among Hispanic patients could be associated with “certain more common types (human leukocyte antigen)” in patients with SSc, a question for which no data currently exist, the researchers wrote.

“Our results may support feature screening (LES) in Hispanic patients with SSc,” Jandali and colleagues wrote. “We believe that understanding the characteristics of the disease and its disparities based on ethnicity, sex (and) geographic distribution is a fundamental and important step in providing the best care for patients with SSc.”



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