{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T12:56:38Z","timestamp":1789217798376,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although traditionally associated with White European ancestry, inflammatory bowel disease (IBD) has increased among different races and ethnicities. Large studies conducted in the United States and Canada have identified more complex disease phenotypes among Black patients. Our study aimed to investigate disparities in IBD treatments and outcomes between Black and White patients in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using the TriNetX database, adult IBD patients were divided into 2 groups based on race: Black and White patients with IBD, Crohn\u2019s disease (CD), or ulcerative colitis (UC). Medical therapy and disease outcomes were evaluated in both groups with 1:1 propensity-score matching. Methodologic limitations include the potential for missing data, lack of information on socioeconomic strata, and patient-level medication coverage plans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In comparison to White patients, Black patients with CD were less likely to receive advanced therapies; Adalimumab (adjusted odds ratio- aOR 0.89), Certolizumab (0.81), Vedolizumab (0.66), Ustekinumab (0.82), or Tofacitinib (0.58). Black patients with UC were less likely to receive advanced therapies; Adalimumab (0.83), Golimumab (0.62), Vedolizumab (0.69), Ustekinumab (0.73), or Tofacitinib (0.55). Black patients with IBD were at higher odds of utilizing corticosteroids (CD 1.18 and UC 1.20) and opioids (CD 1.26 and UC 1.09). Black patients with CD had higher rates of hospitalization (1.35) and perianal abscess (1.56), perianal fistula (1.28), and intestinal fistula (1.38). Black patients with UC had higher rates of hospitalization (1.29), Clostridioides difficile infection (1.11), and toxic megacolon (1.34).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There were racial disparities in IBD medical therapy and disease outcomes. Black IBD patients had lower treatment with advanced therapies, higher opioid and corticosteroid use, and higher IBD-related complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/crocol\/otaf021","type":"journal-article","created":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T04:41:31Z","timestamp":1742100091000},"source":"Crossref","is-referenced-by-count":5,"title":["Racial Disparities in Utilization of Medications and Disease Outcomes in Inflammatory Bowel Disease Patients"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0290-9835","authenticated-orcid":false,"given":"Khaled","family":"Alsabbagh Alchirazi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Aurora Health Care , Milwaukee, WI,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Hamid","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Texas Southwestern Medical Center , Dallas, TX,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4563-3007","authenticated-orcid":false,"given":"Thabet","family":"Qapaja","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Washington University in St. Louis , St. Louis, MO,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Aldiabat","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Washington University in St. Louis , St. Louis, MO,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Azzouz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic , Cleveland, OH,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motasem","family":"Alkhayyat","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Indiana University , Indianapolis, IN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7681-8111","authenticated-orcid":false,"given":"Miguel","family":"Regueiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Cleveland Clinic , Cleveland, OH,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,16]]},"reference":[{"issue":"2","key":"2025042103514605000_CIT0001","doi-asserted-by":"publisher","first-page":"113","DOI":"10.25122\/jml-2018-0075","article-title":"A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease","volume":"12","author":"Seyedian","year":"2019","journal-title":"J Med Life"},{"issue":"5","key":"2025042103514605000_CIT0002","first-page":"339","article-title":"Environmental risk factors for inflammatory bowel disease","volume":"6","author":"Molodecky","year":"2010","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"1","key":"2025042103514605000_CIT0003","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1053\/j.gastro.2016.09.032","article-title":"Genome-wide association study identifies African-specific susceptibility loci in African Americans with inflammatory bowel disease","volume":"152","author":"Brant","year":"2017","journal-title":"Gastroenterology."},{"issue":"12","key":"2025042103514605000_CIT0004","doi-asserted-by":"publisher","first-page":"2634","DOI":"10.1093\/ibd\/izy179","article-title":"Lack of difference in treatment patterns and clinical outcomes between black and white patients with inflammatory bowel disease","volume":"24","author":"Barnes","year":"2018","journal-title":"Inflamm Bowel Dis."},{"issue":"10080","key":"2025042103514605000_CIT0005","doi-asserted-by":"publisher","first-page":"1710","DOI":"10.1016\/S0140-6736(17)30317-3","article-title":"Prediction of complicated disease course for children newly diagnosed with Crohn\u2019s disease: a multicentre inception cohort study","volume":"389","author":"Kugathasan","year":"2017","journal-title":"Lancet."},{"issue":"5","key":"2025042103514605000_CIT0006","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1111\/j.1572-0241.2006.00504.x","article-title":"Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanic Whites: characterization of a large North American cohort","volume":"101","author":"Nguyen","year":"2006","journal-title":"Am J Gastroenterol."},{"issue":"10","key":"2025042103514605000_CIT0007","doi-asserted-by":"publisher","first-page":"2754","DOI":"10.1007\/s10620-007-0190-x","article-title":"Racial differences in disease extent and severity in patients with ulcerative colitis: a retrospective cohort study","volume":"53","author":"Flasar","year":"2008","journal-title":"Dig Dis Sci."},{"issue":"4","key":"2025042103514605000_CIT0008","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.crohns.2013.09.001","article-title":"National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States","volume":"8","author":"Nguyen","year":"2014","journal-title":"J Crohns Colitis."},{"issue":"10","key":"2025042103514605000_CIT0009","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1038\/ajg.2010.202","article-title":"Racial disparities in utilization of specialist care and medications in inflammatory bowel disease","volume":"105","author":"Nguyen","year":"2010","journal-title":"Am J Gastroenterol."},{"issue":"2","key":"2025042103514605000_CIT0010","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1093\/ibd\/izac124","article-title":"The Current State of Care for Black and Hispanic Inflammatory Bowel Disease Patients","volume":"29","author":"Liu","year":"2023","journal-title":"Inflamm Bowel Dis."},{"issue":":28","key":"2025042103514605000_CIT0011","doi-asserted-by":"publisher","DOI":"10.21037\/tgh-23-43","article-title":"Racial and ethnic disparities in clinical presentation, management, and outcomes of patients with inflammatory bowel disease: a narrative review","volume":"9","author":"Venkateswaran","year":"2024","journal-title":"Transl Gastroenterol Hepatol"},{"issue":"12","key":"2025042103514605000_CIT0012","doi-asserted-by":"publisher","first-page":"2903","DOI":"10.2337\/db21-0385","article-title":"Diabetes, drug treatment, and mortality in COVID-19: A Multinational Retrospective Cohort Study","volume":"70","author":"Nyland","year":"2021","journal-title":"Diabetes."},{"issue":"10","key":"2025042103514605000_CIT0013","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1093\/ibd\/izac252","article-title":"Effect of 2 vs 3 Doses of COVID-19 vaccine in patients with inflammatory bowel disease: a population-based propensity matched analysis [published online ahead of print, 2022 Dec 28]","volume":"29","author":"Desai","year":"2022","journal-title":"Inflamm Bowel Dis."},{"issue":"9","key":"2025042103514605000_CIT0014","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1002\/ibd.20483","article-title":"Patterns of infliximab use among Crohn\u2019s disease patients in a community setting","volume":"14","author":"Pressman","year":"2008","journal-title":"Inflamm Bowel Dis."},{"issue":"1","key":"2025042103514605000_CIT0015","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/ibd.20298","article-title":"Disparities in the use of immunomodulators and biologics for the treatment of inflammatory bowel disease: a retrospective cohort study","volume":"14","author":"Flasar","year":"2008","journal-title":"Inflamm Bowel Dis."},{"issue":"3","key":"2025042103514605000_CIT0016","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1002\/ibd.22986","article-title":"Systematic review: the role of race and socioeconomic factors on IBD healthcare delivery and effectiveness","volume":"19","author":"Sewell","year":"2013","journal-title":"Inflamm Bowel Dis."},{"issue":"8","key":"2025042103514605000_CIT0017","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1097\/MIB.0000000000000835","article-title":"Racial and ethnic minorities with inflammatory bowel disease in the United States: a systematic review of disease characteristics and differences","volume":"22","author":"Afzali","year":"2016","journal-title":"Inflamm Bowel Dis."},{"issue":"3","key":"2025042103514605000_CIT0018","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1038\/ajg.2017.479","article-title":"Increased mortality rates with prolonged corticosteroid therapy when compared with antitumor necrosis factor-\u03b1-directed therapy for inflammatory bowel disease","volume":"113","author":"Lewis JD","year":"2018","journal-title":"Am J Gastroenterol."},{"issue":"10","key":"2025042103514605000_CIT0019","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1038\/ajg.2014.230","article-title":"The prevalence and predictors of opioid use in inflammatory bowel disease: a population-based analysis","volume":"109","author":"Targownik","year":"2014","journal-title":"Am J Gastroenterol."},{"issue":"5","key":"2025042103514605000_CIT0020","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: an update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD","volume":"160","author":"Turner D","year":"2021","journal-title":"Gastroenterology."},{"issue":"11","key":"2025042103514605000_CIT0021","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1002\/ibd.20200","article-title":"Race and health insurance are predictors of hospitalized Crohn\u02bcs disease patients undergoing bowel resection","volume":"13","author":"Nguyen","year":"2007","journal-title":"Inflamm Bowel Dis."},{"issue":"5","key":"2025042103514605000_CIT0022","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1002\/ibd.20825","article-title":"Hospitalizations for inflammatory bowel disease: profile of the uninsured in the United States","volume":"15","author":"Nguyen","year":"2009","journal-title":"Inflamm Bowel Dis."},{"issue":"2","key":"2025042103514605000_CIT0023","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s10620-013-2908-2","article-title":"Racial and ethnic differences in health care utilization and outcomes among ulcerative colitis patients in an integrated health-care organization","volume":"59","author":"Li","year":"2014","journal-title":"Dig Dis Sci."},{"issue":"2","key":"2025042103514605000_CIT0024","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1111\/j.1572-0241.2000.t01-1-01531.x","article-title":"Crohn\u2019s Disease: does race matter","volume":"95","author":"Straus","year":"2000","journal-title":"Am J Gastroenterol."},{"issue":"3","key":"2025042103514605000_CIT0025","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1093\/ibd\/izaa090","article-title":"Black and white patients with inflammatory bowel disease show similar biologic use patterns with medicaid insurance","volume":"27","author":"Barnes","year":"2020","journal-title":"Inflamm Bowel Dis."},{"issue":"12","key":"2025042103514605000_CIT0026","doi-asserted-by":"publisher","first-page":"1904","DOI":"10.1093\/ibd\/izac021","article-title":"The relationship between opioid use and healthcare utilization in patients with inflammatory bowel disease: a systematic review and meta-analysis","volume":"28","author":"Sheehan","year":"2022","journal-title":"Inflamm Bowel Dis."},{"issue":"2","key":"2025042103514605000_CIT0027","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.cgh.2017.05.047","article-title":"Ethnicity influences phenotype and outcomes in inflammatory bowel disease: a systematic review and meta-analysis of population-based studies","volume":"16","author":"Shi","year":"2018","journal-title":"Clin Gastroenterol Hepatol."},{"issue":"3","key":"2025042103514605000_CIT0028","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.1097\/MCG.0000000000000117","article-title":"Race and fistulizing perianal Crohn\u2019s disease","volume":"49","author":"Alli-Akintade","year":"2015","journal-title":"J Clin Gastroenterol."},{"issue":"5","key":"2025042103514605000_CIT0029","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1097\/MPG.0b013e3180335bb3","article-title":"Disease presentation and clinical course in black and white children with inflammatory bowel disease","volume":"44","author":"Eidelwein","year":"2007","journal-title":"J Pediat Gastroenterol Nutr"},{"issue":"9","key":"2025042103514605000_CIT0030","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1038\/ng.3359","article-title":"Association analyses identify 38 susceptibility loci for inflammatory bowel disease and highlight shared genetic risk across populations","volume":"47","author":"Liu","year":"2015","journal-title":"Nat Genet."},{"issue":"10","key":"2025042103514605000_CIT0031","doi-asserted-by":"publisher","first-page":"6283","DOI":"10.1128\/AAC.00795-15","article-title":"Racial differences in clostridium difficile infection rates are attributable to disparities in health care access","volume":"59","author":"Mao","year":"2015","journal-title":"Antimicrob Agents Chemother."},{"issue":"1","key":"2025042103514605000_CIT0032","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ajic.2015.08.007","article-title":"Racial and ethnic disparities in health care\u2013associated Clostridium difficile infections in the United States: state of the science","volume":"44","author":"Yang","year":"2016","journal-title":"Am J Infect Control."},{"issue":"1","key":"2025042103514605000_CIT0033","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1186\/s12879-016-1788-4","article-title":"Clostridium difficile infection health disparities by race among hospitalized adults in the United States, 2001 to 2010","volume":"16","author":"Argamany","year":"2016","journal-title":"BMC Infect Dis."},{"issue":"1","key":"2025042103514605000_CIT0034","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3390\/antibiotics12010051","article-title":"National disparities in antibiotic prescribing by race, ethnicity, age group, and sex in United States ambulatory care visits, 2009 to 2016","volume":"12","author":"Young","year":"2023","journal-title":"Antibiotics."},{"issue":"12","key":"2025042103514605000_CIT0035","doi-asserted-by":"publisher","first-page":"e2140798","DOI":"10.1001\/jamanetworkopen.2021.40798","article-title":"Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections","volume":"4","author":"Wurcel","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"3","key":"2025042103514605000_CIT0036","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.cgh.2006.12.027","article-title":"Incidence of Clostridium difficile infection in inflammatory bowel disease","volume":"5","author":"Rodemann","year":"2007","journal-title":"Clin Gastroenterol Hepatol."},{"issue":"11-12","key":"2025042103514605000_CIT0037","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1111\/apt.12073","article-title":"Impact of Clostridium difficile colitis on 5-year health outcomes in patients with ulcerative colitis","volume":"36","author":"Murthy","year":"2012","journal-title":"Aliment Pharmacol Ther."},{"key":"2025042103514605000_CIT0038","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1200\/cci.17.00067","article-title":"Using a federated network of real-world data to optimize clinical trials operations","volume":"2","author":"Topaloglu","year":"2018","journal-title":"JCO Clin Cancer Inform"}],"container-title":["Crohn's &amp; Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otaf021\/62418769\/otaf021.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/7\/2\/otaf021\/62418769\/otaf021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/7\/2\/otaf021\/62418769\/otaf021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T07:52:20Z","timestamp":1745221940000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article\/doi\/10.1093\/crocol\/otaf021\/8079082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,16]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4,10]]}},"URL":"https:\/\/doi.org\/10.1093\/crocol\/otaf021","relation":{},"ISSN":["2631-827X"],"issn-type":[{"value":"2631-827X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2025,3,16]]},"article-number":"otaf021"}}