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Multiple Sclerosis in a Multi-Ethnic Population in Houston, Texas: A Retrospective Analysis

Authors
  • Mercado, Vicki1,
  • Dongarwar, Deepa
  • Fisher, Kristen
  • Salihu, Hamisu M.
  • Hutton, George J.
  • Cuascut, Fernando X.
  • 1 Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
Type
Published Article
Journal
Biomedicines
Publisher
MDPI
Publication Date
Nov 25, 2020
Volume
8
Issue
12
Identifiers
DOI: 10.3390/biomedicines8120534
PMID: 33255552
PMCID: PMC7760789
Source
PubMed Central
Keywords
Disciplines
  • Article
License
Green

Abstract

Multiple Sclerosis (MS) is a progressive neurodegenerative disease that affects more than 2 million people worldwide. Increasing knowledge about MS in different populations has advanced our understanding of disease epidemiology and variation in the natural history of MS among White and minority populations. In addition to differences in incidence, African American (AA) and Hispanic patients have greater disease burden and disability in earlier stages of disease compared to White patients. To further characterize MS in AA and Hispanic populations, we conducted a retrospective chart analysis of 112 patients treated at an MS center in Houston, Texas. Here, we describe similarities and differences in clinical presentation, MRI findings, treatment regimens, disability progression, and relapse rate. While we found several similarities between the groups regarding mean age, disability severity, and degree of brain atrophy at diagnosis, we also describe a few divergences. Interestingly, we found that patients who were evaluated by a neurologist at symptom onset had significantly decreased odds of greater disability [defined as Expanded Disability Status Scale (EDSS) > 4.5] at last presentation compared to patients who were not evaluated by a neurologist (OR: 0.04, 95% CI: 0.16–0.9). We also found that active smokers had significantly increased odds of greater disability both at diagnosis and at last clinical encounter compared to nonsmokers (OR: 2.44, 95% CI: 1.10–7.10, OR= 2.44, 95% CI: 1.35–6.12, p = 0.01, respectively). Additionally, we observed significant differences in treatment adherence between groups. Assessment of the degree of brain atrophy and progression over time, along with an enumeration of T1, T2, and gadolinium-enhancing brain lesions, did not reveal differences across groups.

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