Maxine Mesinger Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Baylor College of Medicine, 7200 Cambridge Street, Suite 9A, Houston, TX, 77030, USA.
Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, USA.
Mult Scler Relat Disord. 2021 Nov;56:103248. doi: 10.1016/j.msard.2021.103248. Epub 2021 Sep 9.
Inter-individual response and tolerability profiles associated with available disease-modifying treatments (DMTs) are an important aspect of the therapeutic decision-making process in multiple sclerosis (MS). In the absence of racially diverse clinical studies, the possible effect of race and ethnicity on treatment outcome remains uncertain. This study aims to compare disease outcome among Hispanic, Black, and White patients with MS, and assess the impact of race/ethnicity on long-term outcome.
A retrospective review of electronic medical records was performed on a multiethnic cohort of MS patients treated in a large academic center. Sociodemographic characteristics, treatment regimens, and disability outcomes were compared between the three groups.
A total of 300 age- and gender-matched MS patients (100 Hispanic, 100 Black, and 100 White) were included in the study. When assessing the overall survival of MS patients without ambulatory disability 5 years from diagnosis, Hispanics and Blacks attained lower survival times compared to Whites (survival time ratio [STR] 0.17, p = 0.004; and 0.14, p = 0.002, respectively). Black patients had the highest rate of disease progression and treatment-limiting adverse events despite similar sociodemographic profiles and DMT exposure relative to Hispanics and Whites.
Racial/ethnic disparities in treatment outcome create an unmet need to identify tailored, multifaceted approaches to therapy selection in MS.
在多发性硬化症（MS）的治疗决策过程中，个体间的反应和耐受性与现有的疾病修正治疗（DMT）相关，这是一个重要方面。在缺乏种族多样化的临床研究的情况下，种族和民族对治疗结果的可能影响仍然不确定。本研究旨在比较西班牙裔、黑人和白人 MS 患者的疾病结局，并评估种族/民族对长期结局的影响。
对一家大型学术中心治疗的多民族 MS 患者队列进行了电子病历的回顾性审查。比较了三组患者的社会人口统计学特征、治疗方案和残疾结局。
本研究共纳入 300 名年龄和性别匹配的 MS 患者（100 名西班牙裔、100 名黑人和 100 名白人）。在评估无活动障碍的 MS 患者从诊断起 5 年后的总体生存率时，西班牙裔和黑人患者的生存时间明显短于白人患者（生存时间比 [STR] 0.17，p=0.004；0.14，p=0.002）。尽管黑人患者的社会人口统计学特征和 DMT 暴露与西班牙裔和白人相似，但他们的疾病进展和治疗相关不良事件发生率最高。
治疗结果的种族/民族差异表明，需要确定针对 MS 患者的量身定制、多方面的治疗选择方法。
