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Real-World Treatment Outcomes in Black, Hispanic, Asian, and White People with Multiple Sclerosis Treated with
Sophia Woodson1, Edward J Gettings2, Chu-Yueh Guo3
1University Hospitals, Cleveland, OH, USA.
Introduction:
Multiple sclerosis (MS) is a heterogeneous disease affecting a diverse population. Compared with white people with MS (PwMS), Black PwMS have more severe disease and higher incidence of MS, whereas Hispanic PwMS experience earlier onset disease; however, MS is not adequately studied in these groups. We compared the effectiveness of fumarates across Black, Hispanic, Asian, and white PwMS.
Methods:
This retrospective analysis using the Komodo Health database included PwMS. Patients with a claim for diroximel fumarate or dimethyl fumarate were followed from disease-modifying therapy (DMT) initiation to loss of follow-up or discontinuation. Outcomes included annualized relapse rate (ARR), time to post-index first relapse, healthcare resource use (HRU), healthcare costs (HCCs), and change in absolute lymphocyte counts (ALCs). Race/ethnicity was self-reported.
Results:
This study included 6800 PwMS (Black, n = 1241; Hispanic, n = 777; Asian, n = 132; white, n = 4650). The average exposure duration of fumarates was 449-559 days. Black PwMS had higher baseline disease burden versus white PwMS, were less likely to have commercial insurance plans, and were more likely to reside in a state with a higher poverty rate. ARRs (12-month pre-index to post-index) were significantly reduced across groups. The Kaplan-Meier estimated proportion of relapse-free patients at 2 years was similar across groups (Black, 77.0%; Hispanic, 75.4%; Asian, 81.7%; white, 80.5%). There was a smaller decline in ALC from month 0 to month 12 in Black PwMS versus other racial/ethnic groups.
Conclusion:
Consistent with prior studies, these results demonstrate the effectiveness of fumarates across racial and ethnic MS subgroups. This is the largest analysis to date of the treatment effects of any individual class of DMT in Black and Hispanic PwMS. Infographic available for this article.
Insights
Fumarate treatments effectively reduced relapse rates in multiple sclerosis (MS) across Black, Hispanic, Asian, and white patients. This study confirms fumarate effectiveness in diverse MS populations.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Multiple sclerosis (MS) exhibits heterogeneity in disease severity and incidence across racial and ethnic groups.
- Black individuals with MS often experience more severe disease, while Hispanic individuals may have an earlier onset.
- Limited research has focused on MS treatment effectiveness in diverse racial and ethnic populations.
Purpose of the Study:
- To compare the effectiveness of fumarate therapies in treating multiple sclerosis across Black, Hispanic, Asian, and white patient populations.
- To analyze treatment outcomes including relapse rates, time to relapse, healthcare resource utilization, and changes in lymphocyte counts.
- To provide insights into fumarate efficacy in understudied racial and ethnic subgroups of people with MS.
Main Methods:
- Retrospective analysis of the Komodo Health database.
- Inclusion of patients with multiple sclerosis (MS) treated with diroximel fumarate or dimethyl fumarate.
- Follow-up from disease-modifying therapy (DMT) initiation to assess outcomes like annualized relapse rate (ARR), time to first relapse, healthcare resource use (HRU), healthcare costs (HCCs), and absolute lymphocyte counts (ALCs).
Main Results:
- The study included 6800 people with MS (PwMS): 1241 Black, 777 Hispanic, 132 Asian, and 4650 white.
- Fumarate treatment led to significant reductions in annualized relapse rates (ARR) across all racial and ethnic groups.
- Relapse-free survival at 2 years was comparable across groups (75.4%–81.7%), with Black PwMS showing a smaller decline in absolute lymphocyte counts (ALCs).
Conclusions:
- Fumarate therapies demonstrate consistent effectiveness in managing multiple sclerosis across diverse racial and ethnic subgroups.
- This study represents the largest analysis to date on the treatment effects of fumarates in Black and Hispanic individuals with MS.
- Findings support the use of fumarates as an effective disease-modifying therapy for a broad range of patients with multiple sclerosis.
