Contributions
Abstract: P839
Type: Poster
Abstract Category: Clinical aspects of MS - Natural course
Background: Few studies have reported increased multiple sclerosis severity in North Africans compared to Caucasian patients. Data available concerning first and second generation immigrants are partial. We aimed to compare multiple sclerosis disability progression between North Africans living in France (NAF), in Tunisia (NAT) and Caucasian patients born and living in France (CF).
Methods: We included Multiple sclerosis patients admitted in the day hospital in Neurology Department at Pitié-Salpêtrière Hospital (France) and Razi hospital (Tunisia). To compare delay to outcomes, logrank tests were used. Univariate and multivariate Cox models were used to determine factors influencing time to EDSS 6.
Results: We consecutively included 462 patients: 171 CF, 151 NAT and 140 NAF (54 first generation (NAF1) and 86 second generation immigrants (NAF2)). Sex ratio, disease forms and delay from disease onset to diagnosis were similar between the groups. NAF differed from other groups with a shorter median time from the onset of the disease to EDSS 3, 4 and 6 and a more frequent incomplete recovery after first relapse (p< 0·0001). Furthermore, the NAF2 differed from the others, having the highest mean progression index and the shortest median time to EDSS 6 in relapsing remitting patients. This group was also characterized by a younger median age at onset (26·5±8·8 years p=0·001) and an increased mean number of relapses during the first 5 years of the disease (6·1 ±3·7, p=0·01) compared to CF. The Cox proportional hazard models demonstrates that i) North African ethnicity is a significant predictor of a fast progression even when adjusting for major covariates, ii) the presence of spinal lesions in initial MRI was a strong predictor for ambulatory disability
Conclusions: Our study further supports severity of multiple sclerosis in North Africans and unravels the particular severity in North Africans living in France, mainly for the second generation.
Disclosure: Dr. Sidhom has nothing to disclose
Dr. Maillart has nothing to disclose
Dr. Tezenas du Montcel has nothing to disclose
Dr. Kacem has nothing to disclose
Dr. Lubetzki has nothing to disclose
Dr. Gouider has nothing to disclose
Dr. Papeix has nothing to disclose
Abstract: P839
Type: Poster
Abstract Category: Clinical aspects of MS - Natural course
Background: Few studies have reported increased multiple sclerosis severity in North Africans compared to Caucasian patients. Data available concerning first and second generation immigrants are partial. We aimed to compare multiple sclerosis disability progression between North Africans living in France (NAF), in Tunisia (NAT) and Caucasian patients born and living in France (CF).
Methods: We included Multiple sclerosis patients admitted in the day hospital in Neurology Department at Pitié-Salpêtrière Hospital (France) and Razi hospital (Tunisia). To compare delay to outcomes, logrank tests were used. Univariate and multivariate Cox models were used to determine factors influencing time to EDSS 6.
Results: We consecutively included 462 patients: 171 CF, 151 NAT and 140 NAF (54 first generation (NAF1) and 86 second generation immigrants (NAF2)). Sex ratio, disease forms and delay from disease onset to diagnosis were similar between the groups. NAF differed from other groups with a shorter median time from the onset of the disease to EDSS 3, 4 and 6 and a more frequent incomplete recovery after first relapse (p< 0·0001). Furthermore, the NAF2 differed from the others, having the highest mean progression index and the shortest median time to EDSS 6 in relapsing remitting patients. This group was also characterized by a younger median age at onset (26·5±8·8 years p=0·001) and an increased mean number of relapses during the first 5 years of the disease (6·1 ±3·7, p=0·01) compared to CF. The Cox proportional hazard models demonstrates that i) North African ethnicity is a significant predictor of a fast progression even when adjusting for major covariates, ii) the presence of spinal lesions in initial MRI was a strong predictor for ambulatory disability
Conclusions: Our study further supports severity of multiple sclerosis in North Africans and unravels the particular severity in North Africans living in France, mainly for the second generation.
Disclosure: Dr. Sidhom has nothing to disclose
Dr. Maillart has nothing to disclose
Dr. Tezenas du Montcel has nothing to disclose
Dr. Kacem has nothing to disclose
Dr. Lubetzki has nothing to disclose
Dr. Gouider has nothing to disclose
Dr. Papeix has nothing to disclose