It is already known that gender plays a role in systemic sclerosis disease with scleroderma – it’s about four times as prevalent in women than men – but a new study brings to light another factor: race. The study, published in the November 4, 2019 issue of the medical journal Rheumatology, looked at just under 10,000 people living with the disease and found distinct differences among black, white and Asian people living with scleroderma.
Scleroderma at a Glance
Scleroderma, also called systemic sclerosis disease, is a chronic condition affecting the connective tissues in the body. The symptoms vary greatly among patients, and the severity of those symptoms is largely dependent on which part of the body is affected. Because each person’s experience with scleroderma is different, the disease can be extremely mild or life-threatening. Approximately 300,000 people in the United States alone live with scleroderma, and about 33% experience the systemic form of the disease. The exact cause of SSc is still unknown, but researchers have concluded that it stems from an overproduction of collagen in the body — how or why is an unsolved mystery.
Study Details and Methods
The study’s authors used the European Scleroderma Trials and Research group database to look for answers. The international team of researchers were seeking differences in the disease process among patients across different races, as well as whether geographic differences played a part in the disease process and progress.
The study’s sample was overwhelmingly white, with 9,162 white people in the sample group. Researchers used the database to find 341 Asian people living with scleroderma, both living in Asia and those living outside of Asia. The smallest sample group was black people, with researchers finding just 181 people in the database — and examined patients living in sub-Saharan Africa and those living in Europe, America and elsewhere.
Study Results
The research showed that the onset of scleroderma in black patients was earlier and faster than either white patients or Asian people living with systemic sclerosis disease, with the exception of Reynaud’s phenomenon as an early onset symptom.
The sample group also showed that black patients had a higher incidence of diffuse skin involvement and a higher mortality directly linked to scleroderma. Black people living with systemic sclerosis disease showed lower levels of anti-topoisomerase-I antibodies (ATA) and anti-centromere antibodies than white or Asian persons living with scleroderma.
Both Asian and black individuals studied by researchers showed a higher instance of pulmonary hypertension and lowered lung capacity and function compared to white individuals in the sample group. Once Reynaud’s phenomenon was present, researchers found that the sample groups that were black and Asian had a higher mortality rate than the white sample group.
Asian individuals in the study showed an earlier disease onset than white individuals, but not as early as the black individuals involved in the study. Asian people living with scleroderma were also noted to have higher ATA levels than white patients, but fewer anti-centromere antibodies. Asian scleroderma patients less commonly experienced diffuse skin involvement than their black or white counterparts in the study.
Study Implications
Researchers noted that the differences among racial groups living with scleroderma were almost entirely independent of geographic location. The study is the largest so far to directly compare racial, ethnic, and geographic differences among scleroderma patients as it relates to the clinical differences in the disease process.
The study, though the largest of its kind, can only point to broad, generalized patterns and may not be applicable to every person living with systemic sclerosis disease. However, the trends and details noted by the study can give patients, doctors and caregivers more insight into how best to live with and treat scleroderma and its symptoms. It also gives a valuable insight into the signs, symptoms, and concerns to be particularly vigilant of in monitoring given a patient’s race and perhaps forms the basis for future studies into the variable factors that can play a part in the progress and process of scleroderma.
By Caitlin Seida from In The Cloud Copy
