New Study Adds to Growing Evidence that Black People with MS May Experience Worse Disease
June 30, 2021
A study of 1,214 Black people with MS and 7,530 white people with MS suggests that at their first study visit, Black people tended to show more severe disease impacts, but these were largely not associated with socioeconomic factors as measured in the study. This snapshot suggests longer-term study is required to understand the cause of those differences and how to address them.
“Association of Disease Severity and Socioeconomic Status in Black and White Americans
With Multiple Sclerosis”
- Recent research suggests that MS can be especially active in Black people. They are more likely to experience more relapses, greater disability, and to require mobility assistance earlier in the disease course than white people.
- For this study, collaborators obtained data from people with MS enrolled in MS PATHS (Multiple Sclerosis Partners Advancing Technology and Health Solutions). This multicenter effort, funded by Biogen, is collecting data on thousands of people with MS using iPAD-delivered evaluations of neurologic function, imaging scans, and blood samples. Participants provide consent for researchers to use and share this information.
- The team looked at data from the first visits of 1,214 participants who identified as Black and 7,530 who identified as white. They compared these groups in terms of self-reported disability, neurologic function assessments, and MRI scans, and also looked at factors including employment and insurance status.
- Black participants were younger, had lower education level, and were less likely to be employed. They were more likely to have Medicaid or Medicare insurance, to report having progressive MS, and to be treated with higher-efficacy (infusion) MS therapies. Black participants had worse neurologic function and greater disability than the white participants, and MRI brain scans showed had more disease activity and tissue damage.
- In a subgroup from one center, the team evaluated socioeconomic status based on zip codes. In this subgroup, socioeconomic factors were associated with slower walking speeds, slower cognitive processing, and slower manual dexterity in white people. Socioeconomic factors were only associated with slower manual dexterity, and not other neurologic outcomes, in Black individuals.
- This study was a snapshot at a specific time point. Longer studies that would track these groups over time are needed to understand whether differences are due to disease-related factors, quality of care, or other factors and offer insights into how to address them. The authors note that MS PATHS is expanding its data collection efforts with this in mind.
- “The results also reinforce the need for more racially representative phase 3 clinical trials,” conclude the authors, saying that such studies can determine whether more aggressive treatment would reduce disability in Black people with MS. One such study is underway.
- Being Black and living with MS brings unique challenges and experiences. Learn more about MS in the Black community and join a virtual, free event, The Black MS Experience Summit, an opportunity to connect with others who understand the distinct experience of life with MS as a Black person.
- Everyone deserves the healthcare they need without discrimination or bias and a provider that knows and supports them. We are working to ensure health equity and address social determinants of health for all communities via our advocacy work.
by Karla Gray-Roncal, MD, Ellen Mowry, MD, (Johns Hopkins University, Baltimore, MD) and colleagues nationwide is published in Neurology
(Published online June 30, 2021).