A RECENT study conducted across five centers in Shelby County, Tennessee, reveals concerning disparities in the diagnosis and severity of axial spondyloarthritis (axSpA) in Black Americans. The retrospective study, which reviewed 244 axSpA cases, found that 32% of patients were Black Americans, highlighting the significant presence of this immune-mediated disease in this population.
Black Americans with axSpA showed distinct clinical differences compared to White patients, including more hip involvement, elevated C-reactive protein levels, and a lower frequency of HLA–B27 positivity. Additionally, Black patients had twice the odds of experiencing advanced grades of sacroiliitis on radiographs, with an odds ratio of 2.32, even after controlling for factors like age and sex.
One of the key findings of the study is the significant diagnostic delay experienced by all patients with axSpA, regardless of race. Diagnostic delays are linked to worse disease outcomes, including increased disease activity and progression. This delay is of particular concern for Black Americans, who may experience more severe manifestations of the disease by the time it is diagnosed.
These results underscore the need for heightened awareness and earlier diagnosis of axSpA in Black Americans. Healthcare providers are urged to consider the unique clinical presentation of this population to improve diagnostic accuracy and outcomes.
Reference: Kommineni K et al. Axial Spondyloarthritis in Black Americans: An Observational Study From Five Centers in Shelby County, Tennessee. ACR Open Rheumatology. doi: 10.1002/acr2.11769.
Anaya Malik | AMJ
