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Systemic sclerosis in Asians: Are there racial differences?

Sue-Ann Ng1,2, Andrea Hsiu Ling Low1,2

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|May 19, 2022
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Summary

Racial factors significantly impact systemic sclerosis (SSc), an autoimmune disease. Asian patients often experience earlier onset, more severe skin involvement, and distinct autoantibodies, potentially affecting survival outcomes.

Keywords:
AsiansSystemic sclerosisclinical manifestationsraceracial differences

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Area of Science:

  • Rheumatology
  • Immunology
  • Genetics

Background:

  • Systemic sclerosis (SSc) is a multisystemic autoimmune disease defined by vasculopathy and fibrosis.
  • Racial and ethnic factors play a crucial role in SSc epidemiology, clinical presentation, autoantibody profiles, genetic predispositions, and mortality.
  • Understanding these racial variations is vital for effective disease management.

Purpose of the Study:

  • To review and analyze the characteristics and outcomes of systemic sclerosis (SSc) specifically in Asian populations.
  • To compare disease patterns in Asian cohorts with those in multi-racial studies.
  • To highlight the influence of race on SSc manifestations and prognosis.

Main Methods:

  • Systematic review of published Asian systemic sclerosis (SSc) cohorts.
  • Analysis of multi-racial cohort studies focusing on racial differences.
  • Evaluation of epidemiological, clinical, genetic, and survival data.

Main Results:

  • Asian patients with systemic sclerosis (SSc) exhibit distinct genetic susceptibilities and tend to have an earlier age of onset.
  • A higher frequency of diffuse skin involvement and specific autoantibodies (e.g., anti-Scl70, anti-U1-RNP) are observed in Asian populations.
  • Evidence suggests potentially poorer survival rates in Asians, possibly linked to disease severity, socioeconomic factors, and healthcare system variations.

Conclusions:

  • Racial background significantly influences the clinical phenotype, genetic factors, and outcomes of systemic sclerosis (SSc).
  • Asian patients present with unique characteristics, including genetic predispositions, distinct autoantibody profiles, and a more severe clinical course.
  • Recognizing race-specific differences in SSc is essential for tailored treatment strategies, monitoring, and prognostication.