Hispanic Patients with Systemic Sclerosis Face Higher Mortality Rates, Study Finds

Hispanic patients with systemic sclerosis are more likely to have concurrent systemic lupus erythematosus (SLE) and U1-RNP positivity, and face greater mortality rates compared to non-Hispanic white patients, according to a recent study published in Arthritis Care & Research.

The study, conducted by Dr. Bochra Jandali and her colleagues from the University of Texas Health Science Center, aimed to explore the disease characteristics and prognosis of Hispanic American patients with systemic sclerosis (SSc) in comparison to other ethnic and racial groups.

The researchers analyzed data from the Genetics versus Environment in Scleroderma Outcome Study, a prospective and observational cohort study that included 427 patients with SSc of fewer than 5 years duration. Among these patients, 124 (29%) were Hispanic, 220 (51.5%) were non-Hispanic white, and 83 (19.5%) were non-Hispanic Black.

At baseline, the study found that Hispanic patients had higher rates of U1-RNP positivity (14% vs. 4.6%; P = .003) and concurrent SLE (4.1% vs. 0.4%; P = .023) compared to non-Hispanic white patients. Additionally, Hispanic patients enrolled at a younger age (median age 46 vs. 51 years) and had longer disease duration (median duration 2.7 vs. 2.1 years).

The study also revealed that Hispanic patients had more restrictive lung disease and perceived higher disability levels compared to non-Hispanic white patients. Hispanic patients showed lower levels of forced vital capacity (mean difference = -9.3%) and higher scores on the modified Health Assessment Questionnaire (mean difference = 0.29).

During a median follow-up period of 3.8 years, Hispanic patients demonstrated a greater risk of death compared to non-Hispanic white patients, regardless of age and gender (HR = 1.67; P = .015).

Furthermore, the study found that Hispanic patients more frequently exhibited limited cutaneous disease and anti-centromere antibodies, compared to non-Hispanic Black patients. They also had lower Rodnan Skin Scores (point estimate = -3.2; P = .029).

While the exact reasons for these differences remain unclear, the researchers suggested that the higher rates of concurrent SLE among Hispanic patients could be linked to certain more common human leukocyte antigen types in patients with SSc. However, more research is needed to confirm this hypothesis.

The findings of this study highlight the importance of screening for SLE features in Hispanic patients with systemic sclerosis. Understanding the disease characteristics and disparities based on ethnicity, sex, and geographical distribution is crucial for providing the best care to SSc patients.