XXXX in an African-American population.

@entity1 @entity31 @entity1960 @entity30 @entity1049
OBJECTIVE: African-Americans have been underrepresented in most large @entity30 ( @entity30 ) trials. This study was undertaken to assess the course and character of @entity30 in African-Americans in comparison with whites. METHODS: We retrospectively compared the course and character of @entity30 in African-American and white @entity1 at 3 Atlanta hospitals. Ninety-nine @entity1 (55 African-American, 44 whites) were enrolled. Telephone interviews and chart reviews were used to identify disease location, presence of fistulae and perirectal disease, surgical history, and medication use. @entity1 with @entity31 or indeterminant @entity1960 , and all non-African-Americans or whites, were excluded. RESULTS: The numbers of male and female @entity1 were similar (50 and 49). Overall, @entity1 comprised 54% of white @entity1 and 47% of African-American @entity1 . There were no significant differences in the setting in which @entity30 were diagnosed, number of flares per year, or duration of symptoms before diagnosis. White @entity1 were more likely to seek care for their @entity30 in a clinic setting, both their primary care physicians (1.31 versus 0.21 visits/yr, P < 0.001) and their gastroenterologists (3.2 versus 2.3 visits/yr, P = 0.03). Small bowel (SB) disease was present more frequently in white @entity1 , 84% versus 65% (P = 0.03), and SB resection was more common in this group, 59% versus 16% (P < 0.01). @entity1049 was more common in African-American @entity1 , 89% versus 63% (P = 0.002). Perirectal fistulae were more frequent in African-American @entity1 , 58% versus 22% (P < 0.001) white @entity1 were more likely to report complete compliance with medical therapy, 77% versus 49% (P = 0.004). African-American @entity1 more frequently discontinued medical therapy because they "felt better" (27% versus 9%, P = 0.02). Medication usage, including immunosuppressants, was similar in both groups, except that white @entity1 were more likely to receive multiple doses of infliximab (34% versus 11%, P = 0.005). Both groups felt equally informed about @entity30 , but white @entity1 felt that their disease was under good control a greater percentage of the time, 71% versus 58% (P = 0.04). CONCLUSIONS: These data lend credence to the suggestion that the nature of @entity30 may be different in African-Americans compared with whites. However, despite this apparent difference in disease manifestation, the contribution of socioeconomic factors, access to health care, and understanding of the disease likely play a role as well.
