TY - JOUR T1 - Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00357-2022 VL - 8 IS - 4 SP - 00357-2022 AU - Gillian C. Goobie AU - Christopher J. Ryerson AU - Kerri A. Johannson AU - Spencer Keil AU - Erin Schikowski AU - Nasreen Khalil AU - Veronica Marcoux AU - Deborah Assayag AU - Hélène Manganas AU - Jolene H. Fisher AU - Martin R.J. Kolb AU - Xiaoping Chen AU - Kevin F. Gibson AU - Daniel J. Kass AU - Yingze Zhang AU - Kathleen O. Lindell AU - S. Mehdi Nouraie Y1 - 2022/10/01 UR - http://openres.ersjournals.com/content/8/4/00357-2022.abstract N2 - Background This multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage experience worse clinical outcomes.Methods The area deprivation index and the Canadian Index of Multiple Deprivation evaluate neighbourhood-level disadvantage in the US and Canada, with higher scores reflecting greater disadvantage. Multivariable linear regression evaluated associations of disadvantage with baseline forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (DLCO) and linear mixed effects models for associations with rate of FVC or DLCO decline, and competing hazards models were used for survival analyses in the US cohort, evaluating competing outcomes of death or lung transplantation. Adjustments were made for age at diagnosis, sex, race and smoking history.Results We included 477 US and 122 Canadian patients with sarcoidosis. Higher disadvantage was not associated with survival or baseline FVC. The highest disadvantage quartile was associated with lower baseline DLCO in the US cohort (β = −6.80, 95% CI −13.16 to −0.44, p=0.04), with similar findings in the Canadian cohort (β = −7.47, 95% CI −20.28 to 5.33, p=0.25); with more rapid decline in FVC and DLCO in the US cohort (FVC β = −0.40, 95% CI −0.70 to −0.11, p=0.007; DLCO β = −0.59, 95% CI −0.95 to −0.23, p=0.001); and with more rapid FVC decline in the Canadian cohort (FVC β = −0.80, 95% CI −1.37 to −0.24, p=0.003).Conclusion Patients with sarcoidosis living in high disadvantage neighbourhoods experience worse baseline lung function and more rapid lung function decline, highlighting the need for better understanding of how neighbourhood-level factors impact individual patient outcomes.Greater neighbourhood disadvantage is associated with worse baseline lung function and more rapid lung function decline in patients with sarcoidosis in both US and Canadian cohorts, highlighting the impact of socioeconomic disparities in this population https://bit.ly/3R8gUuc ER -