Ethnic differences in presentation and treatment of sarcoidosis from the British Thoracic Society (BTS) UK Interstitial Lung Disease (ILD) registry.

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Introduction: Sarcoidosis varies by ethnicity, affecting presentation, comorbidities, and outcomes. Objectives: We aimed to identify ethnic disparities in the presentation and management of UK Sarcoidosis patients. Methods: We analyzed BTS UK ILD registry data (2013–2024), comparing demographics, symptoms, comorbidities, pulmonary function, and outcomes by ethnicity. All patients provided informed consent. Statistical analysis was performed. Results: 736 sarcoidosis patients were included (19% NonWhite - 7% Black African/Caribbean; 8% South Asian, Indian, Pakistani, Bangladeshi (SA); 2% Mixed Ethnicity). NonWhites were younger (52 [42-61] vs 54 [44-62], p<0.001), less often current/ex-smokers (7 vs 30%, p=0.05), and had more comorbidities (40 vs 31%, p=0.029), including TB (7 vs 2%, p<0.001) and diabetes (21 vs 13%, p=0.014). Ischemic heart disease was more frequent in SA (11 vs 7%, p=0.019). NonWhites had more erythema nodosum (10 vs 5%, p=0.027) and fever (3 vs 1%, p=0.044). Despite more prevalent breathlessness in Whites (26 vs 19%, p=0.008), NonWhites had lower baseline FVC and DLCO% (94 [82-107] vs 97% [83-110], p=0.038; 78 [65-90] vs 80% [70-93], p=0.019). Whites had more lymphopenia (32 vs 17%, p=0.002), while Blacks more often had abnormal liver function (21 vs 16%, p=0.013). Pharmacotherapies were similar, but Whites had higher referrals for pulmonary rehab (47 vs 33%, p=0.002) and MDT discussion (57% vs 18%, p=0.032). NonWhites were often from deprived areas (37 vs 24%; IMDQ1&2, p=0.022) Conclusions: Distinct ethnic differences exist in many factors warranting deeper investigation for long-term implications

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