Late Breaking News
More Aggressive Disease
- Categorized in: 2013 Compendium of Federal Medicine, Department of Defense (DoD), Department of Veterans Affairs (VA)
Whatever the reasons for higher incidence rates in blacks compared with whites, research has shown that the disease tends to be more aggressive in African-Americans.
One study published in 2004 examined medical records of 375 African-American (AA) patients with MS compared with 427 Caucasian-Americans (CA) with the disease and found that the median time to ambulation with a cane was six years shorter in AA than in CA subjects (16 vs. 22 years). The median time to wheelchair dependency was eight years shorter in the AA than in CA group (30 vs. 38 years). 3
Researchers attributed the progression of disability in African-Americans to the older age of onset in the study group and to the greater likelihood of transverse myelitis in the African American group, which they said was a predictor of ambulatory disability. Transverse myelitis is a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord.
“It is important to recognize that the clinical manifestations of MS in AA patients differ somewhat from those in CAs and that these differences are likely to be biologically based. AA patients with MS are at high risk for disability; thus, early initiation of treatment seems prudent,” the researchers noted.
A brochure from the National Multiple Sclerosis Society addresses some of the issues surrounding African-Americans and MS, noting, “The myth that African-Americans do not get MS is just that — a myth. African-Americans do get MS. In fact, studies suggest that MS can be especially active in African-Americans.”
The brochure points out that African-Americans are more likely to experience more relapses and greater disability, have an increased risk of progressing to require ambulatory assistance earlier and are more likely to develop involvement of the optic nerves and spinal cord (optico-spinal MS) and inflammation of the spinal cord (transverse myelitis).
1. Wallin MT, Culpepper WJ, Coffman P, Pulaski S, Maloni H, Mahan CM, Haselkorn JK, Kurtzke JF; Veterans Affairs Multiple Sclerosis Centres of Excellence Epidemiology Group. The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service. Brain. 2012 Jun;135(Pt 6):1778-85. doi: 10.1093/brain/aws099. PubMed PMID: 22628389.
2. Deussing EC, Jankosky CJ, Clark LL, Otto JL. Estimated incidence of multiple sclerosis among United States Armed Forces personnel using the Defense Medical Surveillance System. Mil Med. 2012 May;177(5):594-600. PubMed PMID: 22645888.
3. Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA, Glidden D, Weinstock-Guttman B, Reich D, Patterson N, Haines JL, Pericak-Vance M, DeLoa C,Oksenberg JR, Hauser SL. Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis. Neurology. 2004 Dec 14;63(11):2039-45. PubMed PMID: 15596747.
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