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

A retrospective cohort analysis was conducted using Waikato DHB electronic records (2019-2021) for 158 patients with confirmed sarcoidosis. Baseline demographics, radiologic grading, lung function and treatments were collected and analysed. Differences between Māori and NZ European patients were assessed using χ2, 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.