Race and Fistulizing Perianal Crohn’s Disease

BACKGROUND:There is increasing recognition of Crohn’s disease (CD) in non-white populations. However, reports of racial disparities in the phenotype of CD are still inconsistent. AIM:The aim of this study was to test the hypothesis that African American (AA) patients have higher incidence of severe fistulizing perianal Crohn’s disease (FPD) compared with white patients. METHODS:Cross-sectional analysis of 333 adult CD patients treated at The Mount Sinai Hospital with infliximab between May 2011 and December 2011 was conducted. Self-reported race/ethnicity was recorded and proportions of each group with FPD were compared across the population. RESULTS:Among all 333 evaluable CD patients on infliximab, 73.6% were white, 11.4% AA, 13.2% Hispanic, and 1.8% Asian. Of these 333 patients, 88 had FPDonly 48 of these (54.5%) were white, whereas fully 18 (20.5%) were AA, 20 (22.7%) were Hispanic, and 2 (2.3%) were Asian. Thus, patients receiving infliximab for FPD were significantly more likely to be AA or Hispanic than white (AA vs. whitesrisk ratio=2.63; 95% confidence interval, 1.74-3.96; P=