Abstract Details

Title Socioeconomic Disparity Correlates with Faster Inner Retinal Layer Atrophy in Multiple Sclerosis

Topic Multiple Sclerosis

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

Poster/Presentation
Number 171

Objective To evaluate the association between socioeconomic status (SES) and multiple sclerosis (MS) progression and explore whether differential MS management or comorbidity risk mediate this relationship.

Background Limited studies have examined the association of SES with disability aggregation in MS in the US; fewer evaluated SES in relation to MS imaging outcomes, which may be more sensitive.

Design/Methods 789 participants with optical coherence tomography (OCT) and 9-digit zip code available ≤10years of MS onset were included. Zip codes were used to derive neighborhood-level SES indicators: state and national area deprivation indices (ADI) and median household income. Participant-level SES indicators included education level. From OCTs, we derived longitudinal thickness of the ganglion cell/inner plexiform layer (GCIPL), as a surrogate for brain atrophy and disability accumulation. We assessed the association between SES indices (categorized into quartiles) and GCIPL change using multivariable-adjusted mixed effects models. Sensitivity analyses restricted to participants (n=556) with SES indicators available ≤3years of MS onset. We also explored the association between SES and MS therapy management and risk for new comorbidities using Cox models.

Results Higher state and national ADI (most disadvantaged) and lower median household income were associated with faster GCIPL atrophy (Q4 [most disadvantaged] vs. Q1 [least]: State ADI; -0.12µm/year [95%CI:-0.19, -0.04]; p_trend=0.003, national ADI; -0.08µm/year [95%CI:-0.15, -0.005]; p_trend=0.02; median household income: -0.08µm/year [95%CI; -0.16, -0.01]; p_trend=0.03). Increasing years of education were associated with a slower rate of GCIPL decline (Q4 [most education] vs. Q1 [least]: 0.15µm/year [95%CI; 0.06, 0.24]; p_trend=0.003). Low SES individuals tended to escalate therapy earlier (suggesting the observed association between SES and GCIPL atrophy may not entirely be due to differential MS management). Low SES individuals had higher risk of developing new onset comorbidities.

Conclusions Socioeconomic disparity is associated with faster retinal neurodegeneration in MS patients. This association may be potentially partially mediated by differential comorbidity risk.

Authors/Disclosures
Eleni Vasileiou, MD (Mount Sinai) PRESENTER	Dr. Vasileiou has nothing to disclose.
Eleni Vasileiou, MD (Mount Sinai)	Dr. Vasileiou has nothing to disclose.
Grigorios Kalaitzidis, MD (Boston University Medical Center)	Mr. Kalaitzidis has nothing to disclose.
Henrik Ehrhardt, MBBCh (Rutgers - Robert Wood Johnson Medical School)	Henrik Ehrhardt has nothing to disclose.
Jeffrey Lambe, MD	Dr. Lambe has nothing to disclose.
Shiv Saidha, MD (Johns Hopkins)	Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Setpoint Medical. Dr. Saidha has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ReWind Therapeutics. Dr. Saidha 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. Saidha has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Clene Pharmaceuticals. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Saidha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Saidha 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. Saidha has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Saidha has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal ETC. Dr. Saidha has stock in June Brain. Dr. Saidha has stock in Lapix Therapeutics. The institution of Dr. Saidha has received research support from Biogen. The institution of Dr. Saidha has received research support from Genentech. The institution of Dr. Saidha has received research support from Novartis. The institution of Dr. Saidha has received research support from Lapix Therapeutics. The institution of Dr. Saidha has received research support from Novartis.
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Octave. Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SetPoint. The institution of Dr. Mowry has received research support from Genentech/Roche. The institution of Dr. Mowry has received research support from Biogen. Dr. Mowry has received publishing royalties from a publication relating to health care.
Elias S. Sotirchos, MD (Johns Hopkins University)	Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Sotirchos 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. Dr. Sotirchos has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Sotirchos has received research support from National Institutes of Health. The institution of Dr. Sotirchos has received research support from National Multiple Sclerosis Society. The institution of Dr. Sotirchos has received research support from Sumaira Foundation. The institution of Dr. Sotirchos has received research support from Genentech. The institution of Dr. Sotirchos has received research support from UCB. The institution of Dr. Sotirchos has received research support from Astoria Biologica. The institution of Dr. Sotirchos has received research support from Ad Scientiam. The institution of Dr. Sotirchos has received research support from Alexion. The institution of Dr. Sotirchos has received research support from Corevitas. Dr. Sotirchos has received personal compensation in the range of $500-$4,999 for serving as a Ad Hoc Reviewer with National Institutes of Health.
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.
Kathryn Fitzgerald, PhD (Johns Hopkins University)	Dr. Fitzgerald has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Setpoint Medical. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.

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