Abstract Details

Title Impact of Race on Use of Disease-Modifying Therapy in Multiple Sclerosis

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 205

Objective

Background BACKGROUND: MS has been shown to take a more aggressive course in African American (AA) patients as compared with Caucasians. DMT improves outcomes in MS, and the treatment options have increased over the last few years to include more effective yet potentially riskier medications. Racial differences in current DMT utilization may exist and contribute to differences in disease course and disability.

Design/Methods DESIGN/METHODS: The Knowledge Program, a Cleveland Clinic electronic database linked to the Epic electronic medical record, was queried for patients aged 18-65, Caucasian or AA, with MS or clinically isolated syndrome (CIS) in whom treatment status was known. Propensity scores for likelihood of currently being on DMT were estimated based on multiple covariates including age, gender, disease duration, clinical course (relapsing vs progressive), and 25-foot walk times. Subclassification and matching techniques were applied following propensity score estimation to improve covariate balance between treated and untreated patients, and odds ratios were calculated for race in each group.

Results RESULTS: A total of 4630 patients were analyzed, 4075 Caucasians (88%) and 555 AAs (12%). AA patients were found to be younger, more likely to have a progressive course, more likely to have a shorter disease duration, and more likely to require higher levels of walking assistance. Following adjustments for covariate imbalance, no significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT. Additionally, no racial differences were noted between use of first or second line DMTs.

Conclusions CONCLUSIONS: Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role.

Authors/Disclosures
Megan Hyland, MD (University of Rochester) PRESENTER	The institution of Dr. Hyland has received research support from Biogen. The institution of Dr. Hyland has received research support from PCORI.
Jeffrey A. Cohen, MD (Cleveland Clinic)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Convelo. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viatris. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PSI. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celltrion.
Lael Stone, MD	No disclosure on file
Clifford R. Jack, Jr., MD (Mayo Clinic)	The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.

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