Clinical features, treatment and outcomes of sarcoidosis in New Zealand : a comparative study between Māori and New Zealand European patients

BACKGROUND: Sarcoidosis is a multi-system inflammatory disease characterised by granulomas, primarily affecting the respiratory system, but it has extra-thoracic involvement. Sarcoidosis may have different presentations and disease courses based on ethnicity; however, limited data exist on its differences in Māori and New Zealand (NZ) Europeans. AIMS: To investigate the clinical characteristics, treatment and disease progression of sarcoidosis in Waikato District Health Board (DHB) patients, and compare these in Māori and NZ European ethnic groups. METHODS: , analysis of variance and Mann-Whitney tests, with P < 0.05 considered statistically significant. RESULTS: The cohort (mean age: 56 years; 17% Māori, 70% NZ European) exhibited high rates of co-morbidities, notably obesity (46%). There was extra-thoracic involvement in 39% of patients, which was commonly ocular and cutaneous. Diagnosis relied on radiological methods solely or endobronchial ultrasound transbronchial needle aspiration in most cases. Māori patients displayed significantly higher extra-thoracic sarcoidosis involvement (P = 0.045) and lower rates of lung fibrosis. No significant differences were found in lung function decline, respiratory-related hospitalisations or mortality between groups. CONCLUSIONS: Our cohort demonstrates heterogeneous staging and prevalent extra-thoracic manifestations. Māori patients have greater extra-thoracic involvement and lower lung fibrosis than European patients without significant differences in treatment or disease course but with significant metabolic comorbidities. Systemic steroids are well tolerated, but steroid-sparing agent use is limited.