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Ethnic variations may affect long-term survival in systemic sclerosis

09 Sep 2019

Ethnic variations are present in some systemic sclerosis (SSc) disease manifestations, and although this does not lead to significant differences in short-term survival, it may influence long-term survival, suggests a recent study.

A total of 1,005 patients were examined, majority of whom were European-descent white (n=745; 74 percent), Afro-Caribbean (n=58; 6 percent), South Asian (n=70; 7 percent) and East Asian (n=80; 8 percent).

East Asians, compared with European-descent white individuals, had lower incidence of calcinosis (9 percent vs 29 percent; p=0.002) and oesophageal dysmotility (69 percent vs 88 percent; p=0.002), whereas Afro-Caribbeans more frequently had interstitial lung disease (53 percent vs 31 percent), and First Nations individuals more frequently had diffuse cutaneous disease (56 percent vs 35 percent; p=0.02) and diabetes (33 percent vs 5 percent; p=0.03).

There was no difference in short-term survival across ethnicities. Long-term survival was better among Hispanics (81.3 percent, 95 percent CI, 63–100) than European-descent white patients (55 percent, 51–60).

Median survival time appeared to be longest among East Asians (43.3 years) and shortest among Arabs (15 years). No significant difference was observed in median survival times between Afro-Caribbean and European-descent white patients (22.2 vs 22.6 years).

This study included adults who fulfilled the American College of Rheumatology/European League Against Rheumatism classification criteria for SSc between 1970 and 2017. Self-reported ethnicity was categorized as follows: European-descent white, Afro-Caribbean, Hispanic, Arab, East Asian, South Asian, First Nations or Persian.

The time from diagnosis to death from all causes was the primary outcome. Kaplan-Meier survival curves were used to determine survival probabilities and median survival times.

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