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MS incidence higher in African Americans
April 15, 2011

REPORT FROM THE 63rd ANNUAL MEETING OF THE AMERICAN ACADEMY OF NEUROLOGY (AAN), HONOLULU, HAWAII, APRIL 9-16, 2011 - MS is generally described as a disease that primarily affects Caucasians, however, a new study from southern California suggests that the incidence is higher in African Americans than in other racial/ethnic groups (Langer-Gould et al. AAN 2011; abstract P06.032).

A database analysis for the period 2007-2009 identified 607 newly-diagnosed MS cases that met McDonald criteria. The racial/ethnic distribution was 50% Caucasian, 20% African American, 24.5% Hispanic, 2% Asian, and 3.5% other. The MS incidence per 100,000 person-years was 17.7 for African Americans, 12.3 for Caucasians, 4.8 for Hispanics and 1.5 for Asians.

The authors concluded that these findings do not support the belief that African Americans are at lower risk of developing MS. Early recognition and treatment is important due to the severity of MS in this group. Compared to Caucasians, African Americans with MS demonstrate more extensive tissue damage, greater symptom severity, a more rapid disease course and a greater accumulation of disabilities (Weinstock-Guttman et al. Neurology 2010; 74: 538-544; Naismith et al. Mult Scler 2006; 12: 775-781; Kister et al. Neurology 2010; 75: 217-223; Marrie et al. Neurology 2006; 66: 1235-1240).

To date, only one study has been published on the effectiveness of disease-modifying treatment in African Americans. A post-hoc analysis of the EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) trial comparing Rebif and Avonex reported that African Americans (n=36) appeared to be less responsive to beta-interferons (Cree et al. Arch Neurol 2005; 62: 1681-1683). African Americans experienced more relapses, were less likely to be relapse-free, and developed more new T2 lesions in that analysis, however, only T2 lesion count reached statistical significance.

Multiple Sclerosis is a recognized disorder of African Americans, but the problem of MS in this community has not been adequately addressed since members of this group are thought to develop the disease less frequently than European Americans. The most recent studies estimate that African Americans have a less than 50% relative risk of developing MS compared to individuals of primarily Northern European descent. Knowledge of ancestry is important in research studying diseases that behave differently in different ethnic groups. In fact, the study of populations with unique clinical, demographic, and/or historic characteristics has been shown to be extraordinarily informative in deciphering the genetics of cancer and other complex diseases, including MS.

David1949 wrote:I think most African Americans are part caucasian.

Thekla wrote:When you consider the high incidence of vit D3 deficiency in African Americans, particularly noticeable in educated breast-feeding moms, there has to be wide spread deficiency throughout the population.

Socioeconomic status and race/ethnicity have been associated with avoidable procedures, avoidable hospitalizations, and untreated disease (Fiscella, Franks, Gold, & Clancy, 2008).