Rapid disease course in African Americans with multiple sclerosis.

Area of Science:

• Neurology
• Epidemiology
• Medical Informatics

Background:

• Multiple Sclerosis (MS) affects diverse populations differently.
• Comparing disease severity between African American (AA) and White American (WA) MS patients is crucial for understanding health disparities.
• The Multiple Sclerosis Severity Scale (MSSS) offers a standardized method to quantify MS disability relative to disease duration.

Purpose of the Study:

• To evaluate the utility of an MSSS-based classification system for comparing AA and WA MS subpopulations.
• To analyze differences in MS severity and progression rates between AA and WA individuals within the New York State Multiple Sclerosis Consortium (NYSMSC) database.

Main Methods:

• Utilized the NYSMSC database, including 419 AA and 5,809 WA patients with recorded Expanded Disability Status Scale (EDSS) scores.
• Calculated distributions of patients across six MSSS-based severity grades.
• Performed multivariable analyses adjusting for age, gender, disease duration, disease type, and treatment.

Main Results:

• Median MSSS was significantly higher in AA patients (6.0) compared to WA patients (4.8).
• AA patients were overrepresented in the most severe MSSS grades (41.5% vs. 29.3% for WA) and underrepresented in the least severe grades (23.4% vs. 35.4% for WA).
• These differences persisted after adjusting for multiple clinical and demographic factors.

Conclusions:

• The MSSS grading system effectively highlights differences in disease progression between subpopulations.
• Findings indicate that African ancestry is associated with a more rapidly disabling course of multiple sclerosis.