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Social deprivation increases risk of disability in relapsing-remitting and secondary progressive MS
Author(s): ,
F. Calocer
Affiliations:
Neurology, Caen University Hospital
,
O. Dejardin
Affiliations:
INSERM U 1086 ANTICIPE Pôle de Recherche CHU, Caen
,
A. Kwiatkowski
Affiliations:
Neurology, Groupe Hospitalier de l`Institut Catholique de Lille GHICL, Lille
,
B. Bourre
Affiliations:
Neurology Department, Rouen University Hospital, Rouen
,
P. Vermersch
Affiliations:
Neurology, Univ Lille, CHU Lille, LIRIC-INSERM U 995, Lille
,
P. Hautecoeur
Affiliations:
Neurology, Groupe Hospitalier de l`Institut Catholique de Lille GHICL, Lille
,
K. Droulon
Affiliations:
Réseau Bas-Normand pour la SEP, Caen, France
,
M. Abrous
Affiliations:
Neurology, Caen University Hospital
,
D. Chevanne
Affiliations:
Neurology, Caen University Hospital
,
M. Methenni
Affiliations:
Neurology, Groupe Hospitalier de l`Institut Catholique de Lille GHICL, Lille
,
C. Vimont
Affiliations:
Neurology Department, Rouen University Hospital, Rouen
,
F. Deruelle
Affiliations:
Neurology, Univ Lille, CHU Lille, LIRIC-INSERM U 995, Lille
,
L. Guy
Affiliations:
INSERM U 1086 ANTICIPE Pôle de Recherche CHU, Caen
G. Defer
Affiliations:
Neurology, Caen University Hospital; Réseau Bas-Normand pour la SEP, Caen, France
ECTRIMS Online Library. Calocer F. Oct 11, 2018; 228526
Floriane Calocer
Floriane Calocer
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Abstract: P682

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Epidemiology

Introduction: Disability severity varies in Multiple Sclerosis (MS) patients, but all risk factors of disability are not identified yet. Social deprivation known to influence MS healthcare, has been poorly studied as a risk factor of disability until now. To assess social deprivation, ecological indicators such as EDI (European Deprivation Index) are pertinent tools.
Objectives and aims: To identify the influence of social deprivation on the disability progression in MS patients.
Methods: Sociodemographic and clinical data of 3706 patients with a relapsing-remitting MS disease onset between 1982 and 2016, included in the database of 3 MS expert centers (Caen, Rouen, and Lille) were used for analysis. Patients addresses were geolocalized and assigned to an IRIS (Ilots Regroupés pour l'Information Statistique) related to a restricted geographical area. An EDI was attributed to each IRIS code. Comparisons of time to reach an Extended Disability Status Score (EDSS) of 4 (chosen as disability milestone) according to EDI quintiles were made using Kaplan-Meier analysis. Cox proportional hazard models were performed to assess this risk according to EDI with adjustments for gender, MS form, age of disease onset and period of diagnosis.
Results: Mean age at disease onset was 31,8 (±9,9) years old and median time to reach EDSS 4 was 15.6 years 95% CI [14.93 - 16.04]. There was a continuous trend from the lowest to highest EDI with respect to association with the risk of reaching EDSS4 (p-trend< 0,001). The highest level of social deprivation (EDI Q5) was significantly associated with a risk of reaching the disability milestone (EDSS 4) HR=1.50 95% IC [1.28-1.75] compared to less deprived patients (EDI Q1 to Q4).
Conclusions: Social deprivation may contribute to disability risk in MS patients. Differences in access to care as well as other patients 'characteristics than those used as adjustment factors in the analysis should be investigate as possible explanation of this association.
Disclosure: F. Calocer received a fellowship from the "Réseau Bas-Normand pour la SEP" and from the Regional Council of Normandy for carrying out this study and received a travel grant for presenting work to a meeting from ARSEP foundation for MS Research. G. Defer received personal compensation for scientific advisory board from BiogenIdec, Novartis, Genzyme and Teva pharmaceutical Industries Ltd and has received funding for travel and/or speaker honoraria from Merck Serono, BiogenIdec, Novartis, Genzyme and Teva pharmaceutical Industries Ltd. His institution received grants supporting research in his department from Merck Serono, BiogenIdec, and Novartis. B. Bourre serves on scientific advisory board for Merck Serono and has received funding for travel and honoraria from Biogen Idec, Merck Serono, Novartis, Sanofi-Genzyme , Roche and Teva. P. Vermersch received honoraria and consulting fees from Biogen, Sanofi-Genzyme, Novartis, Teva, Merck, Roche, Servier, Celgene, Medday and Almirall and research supports from Biogen, Novartis, Sanofi-Genzyme, Roche and Merck O. Dejardin, A.Kwiatkowski, P.Hautecoeur, K. Droulon, M .Abrous, D. Chevanne, M. Methenni, C. Vimont, F. Deruelle, G. Launoy, have nothing to disclose. Acknowledgement: We would like to thank GENZYME for their support. We thank the French Observatory of Multiple Sclerosis (OFSEP), which is supported by a grant provided by the French State and handled by the “Agence Nationale de la Recherche” within the framework of the “Investments for the Future” program, under the reference ANR-10-COHO-002. We also thank the geographical plateform MAPinMED and “Cancers and Preventions" group for performing geolocalization of our study population of MS patients.

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