Increased Prevalence of MS in Various Patient Subpopulations

In addition to experiencing a higher prevalence of MS, Black individuals often receive a diagnosis at a younger age than do White individuals. (9) They can experience a disproportionately greater number and severity of MS manifestations, such as relapses; poor recovery; visual impairments; and challenges with walking, balancing and coordinating. (12) Their disease typically progresses rapidly, with earlier onset and, ultimately, greater level of disability. (9,12) According to results from a retrospective review of 1,300 patients with MS, Black patients (n = 40) presented with a higher expended disability status scale (EDSS) score at time of diagnosis than did White patients (n = 31 [mean, 2.9 ± 0.2 vs 1.8 ± 0.2; difference between means, 1.1 ± 0.3; P = .0002]). By the 4-to-6-year follow-up, the EDSS score for Black patients (n = 60) grew to nearly double that of White patients (n = 45 [mean, 5.7 ± 1.5 vs 2.9 ± 0.3; difference between means, 2.8 ± 1.7; P = .0008]). With each 1-unit increase of the EDSS score, there was a 1.3 times greater likelihood that the patient was Black rather than White. Black patients also used unilateral assistance devices more often than White patients (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.5-3.5) as well as the use of wheelchairs (HR, 2.5; 95% CI, 1.3-4.5). (13) Although receiving early successful treatment may help delay the advancement of MS-related disability, (14) the more-aggressive progression of MS experienced by Black patients does not appear to be related to a delayed diagnosis of MS or treatment. (13)