Friday, 2 May 2014

MS is not racially prejudiced. It gets you all

Langer-Gould A, Brara SM, Beaber BE, Zhang JL.The incidence of clinically isolated syndrome in a multi-ethnic cohort.J Neurol. 2014 Apr. [Epub ahead of print]

The purpose of this study was to determine the incidence of clinically isolated syndrome (CIS), a potential precursor of multiple sclerosis (MS), and whether it varies by race/ethnicity in a multi-ethnic, population-based cohort. We conducted a retrospective cohort study of over 9 million person-years of observation from the multi-ethnic, community-dwelling members of Kaiser Permanente Southern California Health Plan from January 1, 2008 to December 31, 2010. Incidence of CIS and risk ratios comparing incidence rates between racial/ethnic groups were calculated. 


The average age at diagnosis was 39.0 years (range 2.7-85.8) and 68.8 % were women. The female preponderance was more pronounced among black (75.7 %) and Hispanics (70.5 %) than in white and Asian individuals with CIS (66.5 and 54.5 %, respectively; P = 0.14. With a probability value of P=0.14 really means there was no difference between groups. The most common presenting symptom in Hispanics was optic neuritis (P = 0.008), and in blacks, transverse myelitis (P = 0.07). Incidence of CIS was lower in Hispanics (3.8, 95 % CI 3.2-4.4, P < 0.0001) and Asians (2.4, 95 % CI 1.5-3.6, P < 0.0001) and similar in blacks (6.8, 95 % CI 5.3-8.5, P = 0.30) compared with whites (5.9, 95 % CI 5.1-6.7). The incidence of CIS varies by race/ethnicity and sex in a similar pattern to MS. In addition, the clinical presentation of CIS varies by race/ethnicity. These findings strengthen the probability that the old belief that blacks have a decreased risk of MS is no longer true. These findings highlight that studies that include minorities are likely to lead to important insights into the aetiology and prognosis of CIS and MS.
There you have it yet again that the occurrence of MS can occur just as easily in white people as in black people. So another MS myth of MS is being eroded as it is not just a disease of the whites. If you meet people with MS in East London where we are you see a real mix of races, showing MS is not prejudice it can affect anyone. 

1 comment:

  1. Wow. Dr. G posted my study! I feel famous. I actually met Dr. G at AAN, and he mentioned to me that he would be interested to see if we could tap our data at kaiser to evaluate the risk on multiple sclerosis in HIV patients and to see if antiretrovirals have an effect of multiple sclerosis risk independent of CD4 count. This could be an interesting study to support the EBV hypothesis, but I am not sure that antiretrovirals have any effect on EBV.

    Of note Dr. G, we also have some data on rituxan in prevention of post natalizumab relapses-awaiting more cases before publication.

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