Ambulatory assistance, vision loss linked to greater disability in Black patients with MS
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SAN DIEGO — Black individuals with MS were more disabled than white patients, with higher rates of ambulatory assistance, hospitalization and vision loss driving the difference, per a poster at ACTRIMS 2023.
“In our research, African Americans did worse with the relapsing form [of MS] as well as in the progressive form,” Ghaida Zaid, MD, of the department of neurology at the University of Alabama at Birmingham, told Healio in an interview. “However, Caucasian Americans fared the worst in the progressive phase compared to the relapsing phase.”
Zaid and colleagues sought to examine race-based health disparities between Black and white individuals with MS seeking treatment at the University of Alabama at Birmingham (UAB) hospital.
They conducted a retrospective chart study and identified 500 patients from the UAB Comprehensive MS Center, eventually including 452 patients (n = 304 white, n = 148 Black). Researchers assessed demographics, disease duration, disability score (measured by the Expanded Disability Status Scale), disease onset and patient treatments, and analyzed associations between disability outcome and a range of physical and socioeconomic factors, including age, gender, BMI and type of health insurance.
Results showed that 69.4% of Black patients were hospitalized for an initial MS attack compared with 30.9% of white patients, with vision loss at time of diagnosis seen more often in Black patients (38.3%) than white patients (28.6%).
Further, Black patients were more likely to have higher initial (OR = 2.026) and current (OR = 4.053) EDSS scores and require assistance with walking (OR = 2.793), researchers reported after controlling for gender, BMI, age at diagnosis, disease duration and health insurance status.
Researchers additionally reported that roughly 80% of white patients were diagnosed with relapsing MS with an average disease course of 12.5 years, compared with approximately 90% of Black patients, who had an average disease duration of 9.8 years.
Moreover, Black patients were more likely to experience worsening disability, evidenced by an increase in EDSS score, compared with white patients, after controlling for duration of follow-up (OR = 3.39).
“We are trying to see if we can do a prospective study to see this patient population when they first present [with MS symptoms] and see how they behave in the prospective cohort rather than the retrospective cohort,” Zaid said.