TY - JOUR
T1 - Clinical and MRI characteristics of multiple sclerosis in patients of Middle Eastern and North African ancestry residing in Ontario, Canada
AU - Seyman, Estelle
AU - Jones, Ashley
AU - Guenette, Melanie
AU - Vosoughi, Reza
AU - Selchen, Daniel
AU - Amezcua, Lilyana
AU - Baral, Stefan
AU - Oh, Jiwon
N1 - Funding Information:
The author (s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.O. has received funding from the MS Society of Canada, the National MS Society, EMD Serono, Brain Canada, Roche, and Biogen Idec. The author has also received compensation for consulting or speaking engagements from EMD Serono, Sanofi-Genzyme, Biogen Idec, Novartis, Celgene, and Roche. E.S. has received funding through an unrestricted educational grant from Novartis. She has also received compensation for consulting from Biogen Idec. R.V. has received educational support from Biogen Idec and EMD Serono, honorarium as chair of the LAUNCH program (EMD Serono), honoraria for participation in advisory committees from Biogen Idec, EMD Serono, Genzyme, and Roche, honorarium as speaker from Biogen Idec, grants from CIHR and MHRC for CCSVI trial, and grant from MMSF. D.S. has received personal compensation for consulting or speaking from EMD Serono, Celgene, Sanofi-Genzyme, Biogen Idec, Novartis, Teva, and Roche. L.A. has received funding from the NMSS, NIH NINDS, Biogen Idec, MedDay, and the California Community Foundation. The author has also received compensation for consulting for EMD Serono, Sanofi-Genzyme, Biogen Idec, and Novartis. M.G., A.J., and S.B. have no relevant disclosures.
Publisher Copyright:
© The Author(s), 2020.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Multiple sclerosis (MS) incidence is rising in traditionally low-burden regions, including the Middle East and North Africa (MENA). Objectives: Our objective was to evaluate disease characteristics in MS patients of MENA descent (MENA-MS). Methods: MENA-MS patients and age- and sex-matched MS patients of European descent (EUR-MS) were identified through the MS Clinic Registry of St. Michael’s Hospital in Toronto, Canada. Disease activity and severity were evaluated by the annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, change in the Expanded Disability Status Scale (EDSS), progression index (PI), and MS Severity Score (MSSS). Results: All MS patients within the registry identified to be of MENA origin (n = 192), and age- and sex-matched EUR-MS patients were included. Mean age was 42.9 years, 67% female. A total of 25% and 24% of EUR-MS and MENA-MS had progressive disease, with similar mean disease durations (11.5 and 11.4 years, respectively). Clinical and radiological disease activity (ARR, proportion with new/enlarging MRI lesions) was similar. MENA-MS showed greater disability progression over time (EDSS change = 0.24 vs. 0.06, p = 0.01), a higher MSSS (3.12 vs. 2.67, p = 0.04), and higher PI (0.34 vs. 0.27, p = 0.07). Conclusion: MENA-MS patients demonstrate higher disease severity compared to EUR-MS patients, despite having similar inflammatory measures of disease activity, with disability progression in the absence of relapses. These observations illustrate the importance of the intersections of environmental, socioeconomic, and genetic determinants in optimizing individualized MS care.
AB - Background: Multiple sclerosis (MS) incidence is rising in traditionally low-burden regions, including the Middle East and North Africa (MENA). Objectives: Our objective was to evaluate disease characteristics in MS patients of MENA descent (MENA-MS). Methods: MENA-MS patients and age- and sex-matched MS patients of European descent (EUR-MS) were identified through the MS Clinic Registry of St. Michael’s Hospital in Toronto, Canada. Disease activity and severity were evaluated by the annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, change in the Expanded Disability Status Scale (EDSS), progression index (PI), and MS Severity Score (MSSS). Results: All MS patients within the registry identified to be of MENA origin (n = 192), and age- and sex-matched EUR-MS patients were included. Mean age was 42.9 years, 67% female. A total of 25% and 24% of EUR-MS and MENA-MS had progressive disease, with similar mean disease durations (11.5 and 11.4 years, respectively). Clinical and radiological disease activity (ARR, proportion with new/enlarging MRI lesions) was similar. MENA-MS showed greater disability progression over time (EDSS change = 0.24 vs. 0.06, p = 0.01), a higher MSSS (3.12 vs. 2.67, p = 0.04), and higher PI (0.34 vs. 0.27, p = 0.07). Conclusion: MENA-MS patients demonstrate higher disease severity compared to EUR-MS patients, despite having similar inflammatory measures of disease activity, with disability progression in the absence of relapses. These observations illustrate the importance of the intersections of environmental, socioeconomic, and genetic determinants in optimizing individualized MS care.
KW - Middle East
KW - Multiple sclerosis
KW - North Africa
KW - epidemiology
KW - natural history studies
KW - precision medicine
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U2 - 10.1177/1352458520948212
DO - 10.1177/1352458520948212
M3 - Article
C2 - 32779522
AN - SCOPUS:85089290500
SN - 1352-4585
VL - 27
SP - 1027
EP - 1036
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 7
ER -