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Multiple sclerosis: long‐term outcomes in ethnic minorities. Analysis of a UK population‐based registry
Author(s) -
Alsaeed M. O.,
Harding K. E.,
Williams O. H.,
Willis M. D.,
Hrastelj J.,
Tallantyre E. C.,
Joseph F. G.,
Wardle M.,
Pickersgill T. P.,
Robertson N. P.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13571
Subject(s) - medicine , ethnic group , expanded disability status scale , proportional hazards model , multiple sclerosis , hazard ratio , cohort , population , disease , demography , cohort study , pediatrics , physical therapy , confidence interval , immunology , environmental health , sociology , anthropology
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.