Systemic sclerosis manifestations and clinical outcomes in Hispanics/Latinos of the American Southwest

Abstract

Objective: Certain Hispanic/Latino (Hispanic) populations have been reported to have higher rates and severity of systemic sclerosis; however, little is known of systemic sclerosis in the American Southwest. This study compared manifestations of systemic sclerosis in Hispanics with non-Hispanics of New Mexico. Methods: This cross-sectional longitudinal study included 109 systemic sclerosis patients followed over a mean of 12.6 ± 8.9 years. Subjects were repetitively evaluated including physical examination, echocardiography, chest imaging, and serologic testing and observed for complications. Disease characteristics and long-term outcomes were statistically compared between self-identified Hispanic and non-Hispanic subjects. Results: A total of 73 (67%) systemic sclerosis subjects were Hispanic and 36 (33%) were non-Hispanic. The cohorts were similar in mean age, age of systemic sclerosis onset, limited versus diffuse cutaneous systemic sclerosis, telangiectases, gastroesophageal reflux disease, Raynaud’s phenomenon, autoantibody profile, interstitial lung disease, pulmonary hypertension, scleroderma renal crisis, mortality, and comorbid malignancy (all p > 0.05). However, the standardized mortality ratio was increased in both cohorts relative to age-adjusted mortality: Hispanic: 2.08, confidence interval (1.94–2.24); non-Hispanic: 1.56, confidence interval (1.46–1.68). Furthermore, the standardized incidence ratio for malignancy was increased in both cohorts: Hispanic: 1.45, confidence interval (1.35–1.56); non-Hispanic: 1.24, confidence interval (1.16–1.34). The mean age of cancer diagnosis occurred at a significantly younger age in Hispanics (Hispanics: 53.1 ± 9.7 years; non-Hispanics 63.7 ± 7.9 years; 95% confidence interval: −19 ⩽ 10.6 ⩽ 2.2; p = 0.016). Conclusion: Systemic sclerosis phenotype, autoantibodies, complications, outcomes, malignancy rates, and mortality are generally similar between Hispanics and non-Hispanics with systemic sclerosis in the American Southwest. However, age-adjusted comorbid malignancy and mortality rates are significantly increased in both groups.

A Prospective Observational Study of Disease Severity and Mortality in Hispanic American Patients With Systemic Sclerosis

“…6 Although there were no statistically significant differences in mortality between Hispanic patients and White patients, the 5-year mortality rate was numerically higher in Hispanic patients than in White patients (31.8% vs In another retrospective study conducted at the University of New Mexico, demographic and clinical features of 73 Hispanic patients were compared to 36 non-Hispanic patients. 5 Patients who had an overlap with other connective tissue diseases were excluded. No significant differences in demographic and clinical features or mortality were detected, but Hispanic patients had numerically a higher standardized mortality ratio (1.45 vs 1.24).…”

“…A retrospective study comparing 73 Hispanic patients with 36 non-Hispanic patients did not detect any significant differences in clinical manifestation, but the standardized mortality ratio among Hispanic patients was numerically higher (1.45 vs 1.24). 5 In another retrospective study, Hispanic patients had a significantly younger age at diagnosis. 6 There are no reports of prospective cohort studies focusing on demographic and clinical characteristics of Hispanic American patients with SSc in comparison to other ethnic/racial groups.…”

“…The data regarding SSc characteristics and prognosis in Hispanic Americans are scarce. A retrospective study comparing 73 Hispanic patients with 36 non‐Hispanic patients did not detect any significant differences in clinical manifestation, but the standardized mortality ratio among Hispanic patients was numerically higher (1.45 vs 1.24) 5 . In another retrospective study, Hispanic patients had a significantly younger age at diagnosis 6 …”