Abstract Details

Title Clinical Characteristics and Disease Burden of African, Caribbean, and Black People with Multiple Sclerosis in Toronto, Canada

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 170

Objective To evaluate disease characteristics in African, Caribbean, and Black PwMS(ACB-MS) followed at St. Michael’s Hospital in Toronto, Canada.

Background Heterogeneity in the clinical course among people with multiple sclerosis(PwMS) has been observed between racial and ethnic groups. In the United States, consistent data suggest that Black or African-American(AA) PwMS have greater disease severity compared to non-Black/non-AA people.

Design/Methods ACB-MS were compared with age- and sex-matched PwMS of European descent(EUR-MS) identified through the MS Clinic Registry. Disease activity and severity were evaluated using the annualized relapse rate(ARR), Expanded Disability Status Scale(EDSS) score, MS Severity Score(MSSS), and progression index(PI).

Results 344 patients (n=172 ACB-MS; n=172 EUR-MS; mean age 43 years, 68% female) were included. Mean age of MS onset was 29 years and average disease duration was 14 years in both populations. Relapsing-remitting MS (RRMS) was the most common disease subtype (74% and 71% of ACB-MS and EUR-MS, respectively). Clinical and radiological measures of disease activity were generally similar between ACB-MS and EUR-MS, including ARR (0.47±0.47 vs. 0.41±0.34, p=0.2), most recent EDSS score (median 2.0 in both groups, p=0.10), and proportion of MRIs with new/enlarging T2 lesions (25% worsening in both groups, p=0.76). Disability progression over time was greater in ACB-MS vs. EUR-MS(43% vs 33%, p=0.04) but measures of disease severity, including MSSS(ACB-MS 3.17 vs. EUR-MS 2.58, p=0.3) and PI (ACB-MS 0.27 vs. EUR-MS 0.30, p=0.5) were similar. There was no difference between populations with respect to “higher-efficacy” therapy use(natalizumab, alemtuzumab, ocrelizumab, cladribine, fingolimod) at the most recent visit(p=0.8).

Conclusions MS disease activity and severity were generally comparable between ACB-MS and EUR-MS patients in Toronto, Canada. These findings differ from prior studies demonstrating higher MS disease severity in Black and AA MS populations. Differing environmental, genetic, epigenetic and access to healthcare may explain this observed discrepancy, and further study is warranted.

Authors/Disclosures
Andrea Kuczynski, MD, PhD PRESENTER	Dr. Kuczynski has nothing to disclose.
	No disclosure on file
Dorlan J. Kimbrough, MD (Duke University)	Dr. Kimbrough has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for CVS.
Alexandra Muccilli, MD (Saint Michael's Hospital - Multiple Sclerosis Clinic)	Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Muccilli has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Daniel H. Selchen, MD (St.Michael'S Hospital)	Dr. Selchen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Selchen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. Dr. Selchen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. Selchen has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Teva.
Darin T. Okuda, MD, FAAN (UT Southwestern Medical Center)	Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cortechs AI. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Okuda has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Okuda has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Okuda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Bioscience. Dr. Okuda has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Okuda has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Zenas BioPharma. The institution of Dr. Okuda has received research support from Novartis. The institution of Dr. Okuda has received research support from Alexion. Dr. Okuda has received intellectual property interests from a discovery or technology relating to health care.
Stefan Baral	No disclosure on file
Jiwon Oh, MD, FAAN (St Michael's Hospital)	Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. The institution of Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen-Idec. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD-Serono. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Oh has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen-Idec. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Oh has received research support from Biogen-Idec. The institution of Dr. Oh has received research support from Roche.

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