title: Comparison of the natural history of ulcerative colitis in African Americans and non-Hispanic Caucasians: a historical cohort study.
abstract: BACKGROUND
  There has been an increase in the number of studies on the interaction of African American race and the natural history of inflammatory bowel disease (IBD). However, the results from these studies have been conflicting. We aimed to characterize the natural history of ulcerative colitis (UC) in a cohort of African American patients compared with Caucasian controls.
  
  
  METHODS
  We performed a retrospective chart review of patients with UC who were seen in our IBD Center from 2000 to 2010. In all, 102 African American patients and 209 Caucasian patients were included. We assessed clinical variables related to the natural history of UC as well as outcome variables that reflected disease severity.
  
  
  RESULTS
  African American patients had a shorter median duration (8.0, interquartile range [IQR] = 4.0, 14.0) of UC than Caucasians (10.0, IQR = 6.0, 18.0) (P = 0.006). African American disease patients had more distal disease than controls. African Americans were significantly less likely to use corticosteroids (74.2% vs. 88.8%, P = 0.002), or use immunomodulators (25.8% vs. 69.7%, P < 0.001) than Caucasians. Adjusted multivariate analysis showed that ethnicity was not a risk factor for colectomy (hazard ratio [HR] = 1.6; 95% confidence interval [CI]: 0.78, 3.3).
  
  
  CONCLUSIONS
  There appear to be differences in the natural history of UC in our African American patients when compared with Caucasian controls, while ethnicity was not shown to be a risk factor for colectomy.
authors.affiliation: Department of Gastroenterology and Quantitative Health Sciences, Cleveland Clinic Lerner College of Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Moore
authors.forename: Kristin
authors.initials: K
authors.lastname: Gaffney
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.forename: Bo
authors.initials: B
authors.lastname: Shen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology* / Q000601:surgery; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American
chemical_list: D000305:Adrenal Cortex Hormones; D005765:Gastrointestinal Agents; D007155:Immunologic Factors