Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

African American Scleroderma Patients and Mortality

Arthritis Care Res; ePub 2019 Mar 1; Moore, et al

African American scleroderma patients have more severe pulmonary disease and higher unadjusted mortality than matched non‐African Americans, according to a recent study. Following adjustment for socioeconomic factors, African American race was not a significant risk factor for mortality; however, independent of race, lower median household income predicted increased mortality. A retrospective study comparing African American and non‐African American scleroderma patients seen from 2008‐2016 was performed. Groups were matched by sex, age at first visit, date of first visit, disease duration at first visit, and limited vs diffuse cutaneous disease. Demographic, serologic, and clinical features were compared. Researchers found:

  • African Americans comprised 202 of 402 patients.
  • They demonstrated reduced forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO), more severe lung fibrosis, higher prevalence of pulmonary hypertension, and more severe cardiac involvement.
  • Autoantibody profile statistically differed among the 2 groups.
  • Death during follow‐up was 21% in African Americans vs 11% in non‐African Americans.
  • African American status demonstrated an unadjusted hazard ratio for death during follow‐up of 2.061 that declined with adjustment for socioeconomic covariates to 1.256.


Moore DF, Kramer E, Eltaraboulsi R, Steen VD. Increased morbidity and mortality of scleroderma in African Americans compared to non‐African Americans. [Published online ahead of print March 1, 2019]. Arthritis Care Res. doi:10.1002/acr.23861.

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