title: Race and fistulizing perianal Crohn's disease.
abstract: 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.
  
  
  OBJECTIVE
  : 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 FPD: only 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. whites: risk ratio=2.63; 95% confidence interval, 1.74-3.96; P=<0.0001; Hispanics vs. whites: risk ratio=2.32; 95% confidence interval, 1.54-3.50; P=0.0001). There was no statistically significant difference between AA and Hispanics.
  
  
  CONCLUSIONS
  CD patients at our medical center with FPD requiring infliximab therapy were significantly more likely to be AA or Hispanic.
authors.affiliation: Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Latifat
authors.initials: L
authors.lastname: Alli-Akintade
authors.forename: Patel
authors.initials: P
authors.lastname: Pruthvi
authors.forename: Nicole
authors.initials: N
authors.lastname: Hadi
authors.forename: David
authors.initials: D
authors.lastname: Sachar
mesh_terms: D001741:Black or African American; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001213:Asian; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D000069285:Infliximab; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D010641:Phenotype; D015995:Prevalence; D012003:Rectal Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D014504:Urban Health; D044465:White People
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab