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US-based African Americans with multiple sclerosis have greater disability and lower socio-economic status than Caucasian Americans
Author(s): ,
K. Gray-Roncal
Affiliations:
Johns Hopkins School of Medicine, Baltimore, MD
,
K. Fitzgerald
Affiliations:
Johns Hopkins School of Medicine, Baltimore, MD
,
L. Zhovtis Ryerson
Affiliations:
NYU Langone Medical Center, New York, NY
,
L. Charvet
Affiliations:
NYU Langone Medical Center, New York, NY
,
R. Naismith
Affiliations:
Department of Neurology, Washington University in St. Louis, St. Louis, MO, United States
,
P. Calabresi
Affiliations:
Johns Hopkins School of Medicine, Baltimore, MD
E. Mowry
Affiliations:
Johns Hopkins School of Medicine, Baltimore, MD
ECTRIMS Online Library. Gray-Roncal K. Oct 12, 2018; 228840
Karla Gray-Roncal
Karla Gray-Roncal
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Abstract: P998

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Epidemiology

Background: Clinical observations and emerging studies suggest that African American (AA) people with multiple sclerosis (MS) tend to fare worse than their Caucasian American (CA) counterparts. Existing studies are limited by few AA participants and could often not evaluate other potential contributing factors.
Objective: To compare socio-economic and clinical characteristics of a large population of AA and CA people with MS.
Methods: MS PATHS is a network of 10 large MS centers located in the United States (7) and Europe (3); standardized collection of socio-demographic characteristics, including self-reported racial identity, as well as clinical and disease information are acquired at least annually during routine clinic visits. We included US-based MS PATHS participants with self-reported AA and CA racial identities who provided socio-economic and MS characteristics. We compared AA vs. CA with respect to socio-economic and MS metrics including disability (via Patient Determined Disease Steps [PDDS]) and objective neurological outcomes (via walking speed, manual dexterity and processing speed) using generalized linear models, as appropriate. Models for PDDS and neurologic outcomes were adjusted for age, sex, disease subtype and duration, employment, insurance status.
Results: Of US-based eligible participants in MS PATHS, 909 (14%) identify as AAs while 5842 (86%) identify as CAs and were included in the analyses. Relative to CAs, AAs tended to be younger (Mean 49.7y [standard deviation; SD: 12.3y] vs. 45.6y [12.5]; p< 0.0001), have fewer years of education (14.8y [2.6] vs. 14.1y [2.8]; p< 0.0001), have Medicaid insurance (48% vs. 30%; P< 0.0001) and be currently on disability or not working (29% vs. 39%; p< 0.0001). AAs had a 58% multivariable-adjusted higher odds of severe vs. mild disability relative to CAs (OR: 1.56; 95% CI: 1.21-2.02). They also had significantly slower walking and manual dexterity speeds (multivariable-adjusted mean %difference [95% CI]: 25-foot walking speed: 10% slower [7%-13%]; manual dexterity: 7% slower [5%-9%]) and significantly lower processing speed scores (multivariable-adjusted mean difference -4.32 [-5.09- -3.56]).
Conclusions: In this large sample of AA and CA people with MS, self-reported AA identity was associated with indicators of lower socio-economic status and with greater disease severity across a broad array of neurological assessments.
Disclosure: Karla Gray-Roncal: nothing to disclose.
Kathryn C. Fitzgerald: nothing to disclose.
Lana Zhovtis Ryerson: compensated for serving on Speaker's Burea for Biogen, Genentech, and Teva; advisory boards for Biogen and Celgene. She has research grant from Biogen.
Leigh Charvet: nothing to disclose.
Robert T. Naismith: consulting for Acorda, Alkermes, Biogen, EMD Serono, Genentech, Genzyme, Novartis, and Teva.
Peter A. Calabresi: consulting honoraria from Biogen and DisarmPI on grants to JHU from Annexon, MedImmune, and Sanofi.
Ellen M. Mowry: serving as site PI for clinical trials and studies sponsored by Biogen and SunPharma. She has research support from Sanofi Genzyme and Biogen for investigator-initiated trials, and she receives free medication for a clinical trial, of which she is PI, from Teva Neuroscience. She receives royalties for editorial duties from UpToDate.

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