Epidemiologic Subsets Drive a Differentiated Thoracic and Extrathoracic Presentation of Sarcoidosis: Analysis of 1082 Patients from the Sarcogeas-SEMI Registry

Soledad Retamozo^1,2,3, Roberto Pérez-Alvarez⁴, Guadalupe Fraile⁵, Ricardo Gómez De La Torre⁶, Miguel López Dupla⁷, Begoña De Escalante Yangüela⁸, Ana Alguacil⁹, Joel Chara-Cervantes¹⁰, Jose Velilla Marco¹⁰, Francisco Javier Rascón¹¹, Jose Salvador Garcia Morillo¹², Carles Tolosa¹³, Eva Fonseca Aizpuru¹⁴, Mariona Bonet¹⁵, José Luis Callejas¹⁶, Gloria De la Red¹⁷, Eva Calvo Begueria¹⁸, Cristina Soler i Ferrer¹⁹, Enrique Peral Gutiérrez De Ceballos²⁰, Jorge Francisco Gómez Cerezo²¹, Gracia Cruz Caparrós²², Patricia Perez Guerrero²³, Sergio Rodríguez Fernández²⁴, Blanca Pinilla²⁵, Alberto Gato Diez²⁶, Miriam Akasbi²⁷, Angel Robles²⁸, Inmaculada Ojeda²⁹, Maria José Vives³⁰, César Morcillo³¹, María Penadés Vidal³², Moisés De Vicente³³, Belchin Kostov³⁴, Manuel Ramos-Casals³⁵, Lucio Pallarés¹¹ and Pilar Brito-Zerón², ¹Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Cordoba, Argentina, ²Laboratory of Systemic Autoimmune Diseases “Josep Font”, CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Barcelona, Spain, ³Rheumatology Unit, Hospital Privado Universitario de Córdoba, Institute University of Biomedical Sciences University of Córdoba (IUCBC), Cordoba, Argentina, ⁴Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Vigo, Spain, ⁵Autoimmune Diseases Department, Hospital Ramón y Cajal, Madrid, Spain, ⁶Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Oviedo, Spain, ⁷Department of Internal Medicine, Hospital Universitari Joan XXIII, Tarragona, Tarragona, Spain, ⁸Department of Internal Medicine, Hospital Clínico, Zaragoza, Zaragoza, Spain, ⁹Department of Internal Medicine, Hospital Virgen de la Salud, Toledo, Toledo, Spain, ¹⁰Hospital Universitario Miguel Servet, Zaragoza, Zaragoza, Spain, ¹¹Department of Internal Medicine, Hospital Son Espases. Palma de Mallorca, Palma de Mallorca, Spain, ¹²Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla, Sevilla, Spain, ¹³Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Barcelona, Spain, ¹⁴Department of Internal Medicine, Hospital de Cabueñes, Gijón, Gijón, Spain, ¹⁵Department of Internal Medicine, Althaia, Xarxa Assistencial de Manresa, Manresa, Spain, ¹⁶Department of Internal Medicine, Hospital Clínico San Cecilio, Granada, Granada, Spain, ¹⁷Department of Internal Medicine, Hospital Esperit Sant, Badalona, Badalona, Spain, ¹⁸Hospital General San Jorge, Huesca, Huesca, Spain, ¹⁹Department of Internal Medicine, Hospital de Santa Caterina, Girona, Girona, Spain, ²⁰Department of Internal Medicine, Hospital Virgen Macarena, Sevilla, Sevilla, Spain, ²¹Department of Internal Medicine, Hospital Infanta Sofía, San Sebastián, San Sebastian, Spain, ²²Department of Internal Medicine, Hospital de Poniente El Ejido, Almería, Almería, Spain, ²³Department of Internal Medicine, Hospital Universitario Puerta del Mar, Cádiz, Cadiz, Spain, ²⁴Department of Internal Medicine, Hospital da Barbanza, A Coruña, A Coruña, Spain, ²⁵Department of Internal Medicine, Hospital Gregorio Marañón, Madrid, Madrid, Spain, ²⁶Department of Internal Medicine, Complejo Hospitalario Albacete, Albacete, Albacete, Spain, ²⁷Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Madrid, Spain, ²⁸Internal Medicine, Hospital La Paz, Madrid, Spain, ²⁹Department of Internal Medicine, Hospital Valle del Guadiato, Córdoba, Cordoba, Spain, ³⁰Department of Internal Medicine, Parc Sanitari San Joan de Déu, San Boi de Llobregat, Barcelona, Spain, ³¹Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Barcelona, Spain, ³²Department of Internal Medicine, Hospital De Manises, Valencia, Valencia, Spain, ³³Department of Internal Medicine, Hospital Nuestra Señora del Prado, Talavera, Talavera, Spain, ³⁴Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, CAPSE, Barcelona, Barcelona, Spain, ³⁵Laboratory of Systemic Autoimmune Diseases “Josep Font”, CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Systemic Autoimmune Diseases, ICMID, Hospital Clinic, Barcelona, Spain, Barcelona, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Epidemiologic methods, Ethnic studies and sarcoidosis

Session Information

Date: Sunday, November 5, 2017

Title: Health Services Research Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To analyse whether epidemiologic factors (such as gender or age at diagnosis of the disease) are associated with particular disease expressions and define specific epidemiological subsets in patients with sarcoidosis.

Methods: In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SARCOGEAS) of patients with sarcoidosis. Sarcoidosis was diagnosed in agreement with the criteria proposed by the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) 1999 statement on sarcoidosis. Organ involvement was retrospectively determined in each patient at the time of diagnosis using the 2014 WASOG organ assessment instrument. Ethnicity was defined according to the FDA classification.

Results: The cohort consisted of 1082 patients (82% biopsy-proven), including 618 (57%) women and 464 (43%) men, with a mean age at diagnosis of 47.2 ± 15.5 years. One hundred forty (13%) patients were born outside Spain. With respect to the FDA ethnic classification, 965 (89%) patients were classified as White, 69 (6%) as Hispanic, 30 (3%) as Black/African American and 18 (2%) as Asian. Thoracic involvement was present at diagnosis in 979 (90%) patients, including 437 (40%) patients presenting with stage I, 374 (35%) with stage II, 123 (11%) with stage III and 26 (2%) presenting with stage IV. According to the WASOG classification, the most frequently reported extrathoracic involvements at diagnosis were cutaneous in 385 (36%) patients, extrathoracic lymph nodes in 218 (20%), liver involvement in 151 (14%) and ocular involvement in 118 (11%).

In the multivariate analysis models, women showed a lower frequency of thoracic involvement (87% vs 93% in men, p=0.019) and a higher frequency of cutaneous (42% vs 26%, p<0.001) and ocular (13% vs 9%, p=0.012) WASOG involvements, patients with a younger disease onset (<35 years) were more frequently born out of Spain (17% vs 11%, p=0.027), had a higher frequency of thoracic disease (94% vs 88%, p=0.008) and a lower frequency of kidney involvement (3% vs 6%, p=0.041), and patients with an elderly onset (age>70 years) were more frequently born in Spain (99% vs 86%, p=0.007) and had a lower frequency of thoracic (81% vs 90%, p=0.006) and cutaneous (23% vs 37%, p=0.001) involvements and a higher frequency of bone marrow involvement (12% vs 4%, p=0.004).

Conclusion:

This is one of the largest series of sarcoidosis reported out of the US, predominantly composed by White patients in nearly 90% of cases. Thoracic and extrathoracic involvements at disease presentation were strongly influenced by specific epidemiologic features such as gender, age and ethnicity.

Disclosure: S. Retamozo, None; R. Pérez-Alvarez, None; G. Fraile, None; R. Gómez De La Torre, None; M. López Dupla, None; B. De Escalante Yangüela, None; A. Alguacil, None; J. Chara-Cervantes, None; J. Velilla Marco, None; F. J. Rascón, None; J. S. Garcia Morillo, None; C. Tolosa, None; E. Fonseca Aizpuru, None; M. Bonet, None; J. Luis Callejas, None; G. De la Red, None; E. Calvo Begueria, None; C. Soler i Ferrer, None; E. Peral Gutiérrez De Ceballos, None; J. F. Gómez Cerezo, None; G. Cruz Caparrós, None; P. Perez Guerrero, None; S. Rodríguez Fernández, None; B. Pinilla, None; A. Gato Diez, None; M. Akasbi, None; A. Robles, None; I. Ojeda, None; M. J. Vives, None; C. Morcillo, None; M. Penadés Vidal, None; M. De Vicente, None; B. Kostov, None; M. Ramos-Casals, None; L. Pallarés, None; P. Brito-Zerón, None.

To cite this abstract in AMA style:

Retamozo S, Pérez-Alvarez R, Fraile G, Gómez De La Torre R, López Dupla M, De Escalante Yangüela B, Alguacil A, Chara-Cervantes J, Velilla Marco J, Rascón FJ, Garcia Morillo JS, Tolosa C, Fonseca Aizpuru E, Bonet M, Luis Callejas J, De la Red G, Calvo Begueria E, Soler i Ferrer C, Peral Gutiérrez De Ceballos E, Gómez Cerezo JF, Cruz Caparrós G, Perez Guerrero P, Rodríguez Fernández S, Pinilla B, Gato Diez A, Akasbi M, Robles A, Ojeda I, Vives MJ, Morcillo C, Penadés Vidal M, De Vicente M, Kostov B, Ramos-Casals M, Pallarés L, Brito-Zerón P. Epidemiologic Subsets Drive a Differentiated Thoracic and Extrathoracic Presentation of Sarcoidosis: Analysis of 1082 Patients from the Sarcogeas-SEMI Registry [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/epidemiologic-subsets-drive-a-differentiated-thoracic-and-extrathoracic-presentation-of-sarcoidosis-analysis-of-1082-patients-from-the-sarcogeas-semi-registry/. Accessed .

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