{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:37:05Z","timestamp":1789141025412,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100011684","name":"Crohn's and Colitis Foundation","doi-asserted-by":"publisher","award":["567497"],"award-info":[{"award-number":["567497"]}],"id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK034987"],"award-info":[{"award-number":["P30DK034987"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prior studies have identified racial disparities in the treatment and outcomes of inflammatory bowel disease (IBD). These disparities could be secondary to differences in biology, care delivery, or access to appropriate therapy. The primary aim of this study was to compare medication use among Medicaid-insured black and white patients with IBD, given uniform access to gastroenterologists and therapies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed Medicaid Analytic eXtract data from 4 states (California, Georgia, North Carolina, and Texas) between 2006 and 2011. We compared the use of IBD-specific therapies, including analyses of postoperative therapy among patients with Crohn disease (CD). We performed bivariate analyses and multivariable logistic regression, adjusting for potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 14,735 patients with IBD (4672 black [32%], 8277 with CD [58%]). In multivariable analysis, there was no significant difference in the odds of anti-tumor necrosis factor use by race for CD (adjusted odds ratio [aOR] = 1.13; 95% confidence interval [CI], 0.99-1.28] or ulcerative colitis (aOR = 1.12; 95% CI, 0.96-1.32). Black patients with CD were more likely than white patients to receive combination therapy (aOR = 1.50; 95% CI, 1.15-1.96), and black patients were more likely than white patients to receive immunomodulator monotherapy after surgery for CD (31% vs 18%; P = 0.004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In patients with Medicaid insurance, where access to IBD-specific therapy should be similar for all individuals, there was no significant disparity by race in the utilization of IBD-specific therapies. Disparities in IBD treatment discussed in prior literature seem to be driven by socioeconomic or other issues affecting access to care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izaa090","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T06:18:04Z","timestamp":1589437084000},"page":"364-370","source":"Crossref","is-referenced-by-count":16,"title":["Black and White Patients With Inflammatory Bowel Disease Show Similar Biologic Use Patterns With Medicaid Insurance"],"prefix":"10.1093","volume":"27","author":[{"given":"Edward L","family":"Barnes","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology , Chapel Hill, North Carolina, USA"},{"name":"and Disease, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M","family":"Bauer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S","family":"Sandler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology , Chapel Hill, North Carolina, USA"},{"name":"and Disease, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Kappelman","sequence":"additional","affiliation":[{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology , Chapel Hill, North Carolina, USA"},{"name":"and Disease, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Millie D","family":"Long","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"},{"name":"Center for Gastrointestinal Biology , Chapel Hill, North Carolina, USA"},{"name":"and Disease, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"2022092610002688200_CIT0001","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1053\/j.gastro.2011.10.001","article-title":"Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review","volume":"142","author":"Molodecky","year":"2012","journal-title":"Gastroenterology."},{"key":"2022092610002688200_CIT0002","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/ibd.20029","article-title":"Update on the incidence and prevalence of Crohn\u2019s disease and ulcerative colitis in Olmsted County, Minnesota, 1940-2000","volume":"13","author":"Loftus","year":"2007","journal-title":"Inflamm Bowel Dis."},{"key":"2022092610002688200_CIT0003","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1136\/gut.46.3.336","article-title":"Ulcerative colitis in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival","volume":"46","author":"Loftus","year":"2000","journal-title":"Gut."},{"key":"2022092610002688200_CIT0004","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/S0016-5085(98)70421-4","article-title":"Crohn\u2019s disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival","volume":"114","author":"Loftus","year":"1998","journal-title":"Gastroenterology."},{"key":"2022092610002688200_CIT0005","doi-asserted-by":"crossref","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."},{"key":"2022092610002688200_CIT0006","doi-asserted-by":"crossref","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."},{"key":"2022092610002688200_CIT0007","doi-asserted-by":"crossref","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."},{"key":"2022092610002688200_CIT0008","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/MIB.0000000000000325","article-title":"Racial disparities in readmission, complications, and procedures in children with Crohn\u2019s disease","volume":"21","author":"Dotson","year":"2015","journal-title":"Inflamm Bowel Dis."},{"key":"2022092610002688200_CIT0009","doi-asserted-by":"crossref","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."},{"key":"2022092610002688200_CIT0010","doi-asserted-by":"crossref","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 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United States","volume":"15","author":"Nguyen","year":"2009","journal-title":"Inflamm Bowel Dis."},{"key":"2022092610002688200_CIT0030","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1016\/j.cgh.2006.09.026","article-title":"Racial and geographic variations in colectomy rates among hospitalized ulcerative colitis patients","volume":"4","author":"Nguyen","year":"2006","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2022092610002688200_CIT0031","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1097\/MIB.0000000000001267","article-title":"Minority pediatric patients with inflammatory bowel disease demonstrate an increased length of stay","volume":"23","author":"Barnes","year":"2017","journal-title":"Inflamm Bowel Dis."}],"container-title":["Inflammatory Bowel 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