Sarcoidosis Doubles Mortality Rate in Black Women

SAN FRANCISCO – Black women with a history of sarcoidosis have a mortality rate twice that of women without sarcoidosis, according to an analysis of data from approximately 59,000 women in the Black Women’s Health Study during 1995-2009.

The age-adjusted mortality rate was 17/10,000 person-years in black women with a history of sarcoidosis and 8/10,000 person-years in those without a history of sarcoidosis, Dr. Melissa H. Tukey reported.

A total of 686 women had a diagnosis of sarcoidosis at the start of the Black Women's Health Study in 1995, and 506 women developed sarcoidosis during follow-up; of these, 121 died. Among the remaining women without sarcoidosis, 2,813 died. Cumulative mortality rates were 10% in those with sarcoidosis and 5% in those without sarcoidosis, Dr. Tukey and her associates reported in a poster presentation and discussion at an international conference of the American Thoracic Society.

Sarcoidosis was the leading cause of death in women with the disease who died. Of deaths among women with a history of sarcoidosis, 24% were directly attributable to the disease, and 47% of these deaths were caused by respiratory failure, an analysis of National Death Index data showed. Another 6% died from pulmonary fibrosis or pulmonary hypertension.

The current analysis is the largest epidemiologic study specifically focused on mortality in black women with sarcoidosis, said Dr. Tukey of Boston University. Previous data suggesting that African American women are disproportionately affected by sarcoidosis and have a higher mortality from the disease come primarily from single-site studies, she added.

Other causes of death among black women with a history of sarcoidosis in the Black Women’s Health Study were listed as cancer in 23%, infection in 11%, coronary artery disease in 8%, other cardiac disease in 10%, chronic obstructive pulmonary disease in 2%, and other causes in 16%.

In each age category at the end of the follow-up period, the all-cause mortality rate among women with a history of sarcoidosis was higher than for women with no history of sarcoidosis.

For most black women with sarcoidosis, "it’s primarily a benign disease," Dr. Tukey said. "But there is this cohort of patients that just have a more progressive and severe course, and often end up dying of their disease. Now we’re finally able to really quantify what that actual risk is."

A clinician who has a female black patient with sarcoidosis who starts to develop pulmonary fibrosis or signs of severe disease should discuss the option of more aggressive treatment with the patient, she suggested.

The Black Women’s Health Study relied on self-report of a sarcoidosis diagnosis, but Dr. Tukey and her associates confirmed the diagnosis in 96% of patients for whom medical records or physician checklists were obtained. The Black Women’s Health Study is not a random sample of black women in the United States, so results may not be generalizable to the entire population of black women.

Dr. Tukey reported having no financial disclosures.

SAN FRANCISCO – Black women with a history of sarcoidosis have a mortality rate twice that of women without sarcoidosis, according to an analysis of data from approximately 59,000 women in the Black Women’s Health Study during 1995-2009.

The age-adjusted mortality rate was 17/10,000 person-years in black women with a history of sarcoidosis and 8/10,000 person-years in those without a history of sarcoidosis, Dr. Melissa H. Tukey reported.

A total of 686 women had a diagnosis of sarcoidosis at the start of the Black Women's Health Study in 1995, and 506 women developed sarcoidosis during follow-up; of these, 121 died. Among the remaining women without sarcoidosis, 2,813 died. Cumulative mortality rates were 10% in those with sarcoidosis and 5% in those without sarcoidosis, Dr. Tukey and her associates reported in a poster presentation and discussion at an international conference of the American Thoracic Society.

Sarcoidosis was the leading cause of death in women with the disease who died. Of deaths among women with a history of sarcoidosis, 24% were directly attributable to the disease, and 47% of these deaths were caused by respiratory failure, an analysis of National Death Index data showed. Another 6% died from pulmonary fibrosis or pulmonary hypertension.

The current analysis is the largest epidemiologic study specifically focused on mortality in black women with sarcoidosis, said Dr. Tukey of Boston University. Previous data suggesting that African American women are disproportionately affected by sarcoidosis and have a higher mortality from the disease come primarily from single-site studies, she added.

Other causes of death among black women with a history of sarcoidosis in the Black Women’s Health Study were listed as cancer in 23%, infection in 11%, coronary artery disease in 8%, other cardiac disease in 10%, chronic obstructive pulmonary disease in 2%, and other causes in 16%.

In each age category at the end of the follow-up period, the all-cause mortality rate among women with a history of sarcoidosis was higher than for women with no history of sarcoidosis.

For most black women with sarcoidosis, "it’s primarily a benign disease," Dr. Tukey said. "But there is this cohort of patients that just have a more progressive and severe course, and often end up dying of their disease. Now we’re finally able to really quantify what that actual risk is."

A clinician who has a female black patient with sarcoidosis who starts to develop pulmonary fibrosis or signs of severe disease should discuss the option of more aggressive treatment with the patient, she suggested.

The Black Women’s Health Study relied on self-report of a sarcoidosis diagnosis, but Dr. Tukey and her associates confirmed the diagnosis in 96% of patients for whom medical records or physician checklists were obtained. The Black Women’s Health Study is not a random sample of black women in the United States, so results may not be generalizable to the entire population of black women.

Dr. Tukey reported having no financial disclosures.

SAN FRANCISCO – Black women with a history of sarcoidosis have a mortality rate twice that of women without sarcoidosis, according to an analysis of data from approximately 59,000 women in the Black Women’s Health Study during 1995-2009.

The age-adjusted mortality rate was 17/10,000 person-years in black women with a history of sarcoidosis and 8/10,000 person-years in those without a history of sarcoidosis, Dr. Melissa H. Tukey reported.

A total of 686 women had a diagnosis of sarcoidosis at the start of the Black Women's Health Study in 1995, and 506 women developed sarcoidosis during follow-up; of these, 121 died. Among the remaining women without sarcoidosis, 2,813 died. Cumulative mortality rates were 10% in those with sarcoidosis and 5% in those without sarcoidosis, Dr. Tukey and her associates reported in a poster presentation and discussion at an international conference of the American Thoracic Society.

Sarcoidosis was the leading cause of death in women with the disease who died. Of deaths among women with a history of sarcoidosis, 24% were directly attributable to the disease, and 47% of these deaths were caused by respiratory failure, an analysis of National Death Index data showed. Another 6% died from pulmonary fibrosis or pulmonary hypertension.

The current analysis is the largest epidemiologic study specifically focused on mortality in black women with sarcoidosis, said Dr. Tukey of Boston University. Previous data suggesting that African American women are disproportionately affected by sarcoidosis and have a higher mortality from the disease come primarily from single-site studies, she added.

Other causes of death among black women with a history of sarcoidosis in the Black Women’s Health Study were listed as cancer in 23%, infection in 11%, coronary artery disease in 8%, other cardiac disease in 10%, chronic obstructive pulmonary disease in 2%, and other causes in 16%.

In each age category at the end of the follow-up period, the all-cause mortality rate among women with a history of sarcoidosis was higher than for women with no history of sarcoidosis.

For most black women with sarcoidosis, "it’s primarily a benign disease," Dr. Tukey said. "But there is this cohort of patients that just have a more progressive and severe course, and often end up dying of their disease. Now we’re finally able to really quantify what that actual risk is."

A clinician who has a female black patient with sarcoidosis who starts to develop pulmonary fibrosis or signs of severe disease should discuss the option of more aggressive treatment with the patient, she suggested.

The Black Women’s Health Study relied on self-report of a sarcoidosis diagnosis, but Dr. Tukey and her associates confirmed the diagnosis in 96% of patients for whom medical records or physician checklists were obtained. The Black Women’s Health Study is not a random sample of black women in the United States, so results may not be generalizable to the entire population of black women.

Dr. Tukey reported having no financial disclosures.