Multiple sclerosis: long-term outcomes in ethnic minorities. Analysis of a UK population-based registry

Eur J Neurol. 2018 Apr;25(4):701-704. doi: 10.1111/ene.13571. Epub 2018 Feb 16.

Abstract

Background and purpose: Multiple sclerosis (MS) is most frequent in Caucasian populations. However, studies of MS in other ethnic groups may offer unique insights into genetic and environmental influences on the disease, and data on long-term outcomes in these patients is limited. In this work clinical features and time to disability milestones were investigated in ethnic minority (EM) patients with MS in a UK population and comparisons were made to a Caucasian cohort from the same region.

Methods: In all, 1949 MS patients (1866 Caucasian, 83 EM) were identified from a regional disease registry. Cox proportional hazards regression was used to analyse the time to Expanded Disability Status Scale (EDSS) 3.0, 4.0 and 6.0.

Results: Ethnic minority patients were younger at disease onset (28.6 years vs. 32.8 years, P = 0.001), and primary progressive MS was less common (EM 4.8%, Caucasian 11.6%, P = 0.03). After correction for clinical variables, ethnicity was associated with time to EDSS 3.0 [EM: hazard ratio (HR) 1.75, P < 0.0001] and 4.0 (HR 1.46, P = 0.03), but not 6.0 (HR 1.5, P = 0.05).

Conclusions: Ethnic minority patients reach early levels of fixed disability more rapidly than Caucasian patients, but this effect diminishes at later stages of the disease. This has implications for clinical management of these patients.

Keywords: epidemiology; multiple sclerosis.

MeSH terms

  • Adult
  • Age of Onset
  • Asian People
  • Black People
  • Cohort Studies
  • Cross-Sectional Studies
  • Disability Evaluation
  • Disease Progression
  • Ethnicity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Multiple Sclerosis / epidemiology*
  • Population
  • Prognosis
  • Prospective Studies
  • Registries
  • Treatment Outcome
  • United Kingdom / epidemiology
  • White People