#AANAM – Disease Severity, Job Loss Higher in Black Than White Patients in US

Marisa Wexler MS avatar

by Marisa Wexler MS |

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MS and racial disparities US

Editor’s note: The Multiple Sclerosis News Today team is providing in-depth coverage of the 2021 Virtual AAN Annual Meeting, April 17–22. Go here to read the latest stories from the conference.

African Americans with relapsing-remitting multiple sclerosis (RRMS) are more likely than white patients — despite comparable disease durations and education levels — to be unemployed or earning less than $15,000 a year, and to have more severe disability, an analysis found.

And Hispanics in the U.S., especially Black Hispanics, are less likely to use disease-modifying MS treatments than are other racial or ethnic patient groups.

These findings “show disparities of sociodemographic and clinical characteristics of patients with MS,” said Victor Rivera, MD, a professor at Baylor College of Medicine, during their presentation at the annual meeting of the American Academy of Neurology (AAN), running online through April 22.

Rivera’s talk was titled, “Sociodemographic and Clinical Characteristics of Patients With Multiple Sclerosis by Race and Ethnicity (NARCRMS Registry).” The analysis was funded by Biogen.

The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS) is a physician-based registry with health and demographic data on MS patients between the ages of 18 and 50 in the U.S. and Canada.

Rivera presented clinical and demographic characteristics of 722 people added to this registry between late 2016 and mid-2020. These patients had a mean age of 40.1, and 71% were female.

Of the 695 patients living in the U.S., 84% were white and 11% were Black, and about a quarter were ethnically Hispanic. The amount of time since symptom onset and diagnosis was comparable between Black and white patients.

These two groups also had similar levels of education, but unemployment rates were significantly higher among Blacks (8% vs. 3%). Black MS patients were also significantly more likely to have an annual income of less than $15,000 compared with white patients (16% vs. 6%). Income rates were lowest among Black Hispanics than other racial or ethnic groups.

“Occupation and income status are disparate between Black/African American and white patients with MS, despite comparable educational attainment,” Rivera said.

Most of these patients (73%) had relatively mild disability, as evidenced by a score of 2.5 or lower on the Expanded Disability Status Scale (EDSS).

But rates of substantial disability — an EDSS score of 4.0 or higher — were more than twice as high among Black with RRMS than whites (21% vs. 10%). Hispanics had slightly higher substantial disability than did non-Hispanics (14% vs. 10%).

“Black/African American patients present with more severe MS-related disability than do white patients,” Rivera said.

A majority of this patient group, 57%, were treated with oral or injectable disease-modifying therapies (DMTs), or treatments proven in clinical trials to ease the course of MS.

Rates of DMT use, however, were significantly lower among Hispanics than non-Hispanics (43% vs. 62%), and lowest among Black Hispanics (26%) of all these racial or ethnic groups. Across ethnicities, rates of DMT use were lower among Black patients than whites.

“Fewer Hispanic than non-Hispanic patients with MS, and fewer Black/African American than white patients with MS, are treated with disease-modifying therapies,” Rivera concluded.

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