Contributions
Abstract: P849
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Objective: o compare the clinical characteristics and treatment patterns in Hispanic MS patients residing in Mexico and in Southern USA of Mexican background.
Methods: A total of 424 Mexican and US Mexicans living in southern California participated in separate outcome registries were evaluated. US self-reported Mexican ethnicity (n=170) were abstracted from the registry with similar disease duration to Mexican cases (n=254). The cohort was then stratified by place of birth: US-born, immigrant to the US from Mexico, and Mexican. Clinical and demographic characteristics and disability (measured by EDSS ) were compared between the groups using multivariable analysis (ANOVA) with adjustment for multiple testing (Tukey).
Results: There were no significant differences in gender (p=0.91) and disability (p=0.06). Family history of MS was significantly higher in the US-born (14%, p-value=0.005) compared to immigrant (7%) or Mexican (4%). Disease course varied by birth and migration status with greater progressive type of MS in Mexicans (24%) compared to others (9% in immigrants vs. 4% US-born, p =0.005). Compared to US-born and Mexicans, the immigrant had older age of MS onset (7.0-7.3 years on average, 95% CI ranged 4.4-9.7). This difference persisted after limiting the analysis to relapsing MS only and adjusting for gender and family history of MS. We also observed differences in clinical treatment by birth and migrant status. Mexicans were more frequently treated with azathioprine and cyclophosphamide (32%) compared to others (p-value< 0.0001). Clinical presentation also varied significantly (p< 0.001) by birth and migrant status. The initial symptoms for Mexicans were more likely to involve brainstem/cerebellum (47% vs. 19% vs. 19%) compared to US-born and immigrants and less likely to present with visual symptoms (24% vs. 39% vs. 37%, p=0.008) respectively.
Conclusions: Differences in disease course and clinical presentation were observed by birth and migration status, which may reflect differences in ancestry. The treatment differences observed between Mexican patients compared to US-Mexicans may reflect difference in clinical practice and accessibility to treatment to each.
Disclosure: Drs. Flores, Rivas, Rito and Corona have nothing to disclose.
Drs. Amezcua, Islam and Guerrero have nothing to disclose. Ms. Palomeque has nothing to disclose.
Funding source: The USC Hispanic MS Registry is supported by the Kim Foundation (PI: L. Amezcua).
Abstract: P849
Type: Poster
Abstract Category: Clinical aspects of MS - Epidemiology
Objective: o compare the clinical characteristics and treatment patterns in Hispanic MS patients residing in Mexico and in Southern USA of Mexican background.
Methods: A total of 424 Mexican and US Mexicans living in southern California participated in separate outcome registries were evaluated. US self-reported Mexican ethnicity (n=170) were abstracted from the registry with similar disease duration to Mexican cases (n=254). The cohort was then stratified by place of birth: US-born, immigrant to the US from Mexico, and Mexican. Clinical and demographic characteristics and disability (measured by EDSS ) were compared between the groups using multivariable analysis (ANOVA) with adjustment for multiple testing (Tukey).
Results: There were no significant differences in gender (p=0.91) and disability (p=0.06). Family history of MS was significantly higher in the US-born (14%, p-value=0.005) compared to immigrant (7%) or Mexican (4%). Disease course varied by birth and migration status with greater progressive type of MS in Mexicans (24%) compared to others (9% in immigrants vs. 4% US-born, p =0.005). Compared to US-born and Mexicans, the immigrant had older age of MS onset (7.0-7.3 years on average, 95% CI ranged 4.4-9.7). This difference persisted after limiting the analysis to relapsing MS only and adjusting for gender and family history of MS. We also observed differences in clinical treatment by birth and migrant status. Mexicans were more frequently treated with azathioprine and cyclophosphamide (32%) compared to others (p-value< 0.0001). Clinical presentation also varied significantly (p< 0.001) by birth and migrant status. The initial symptoms for Mexicans were more likely to involve brainstem/cerebellum (47% vs. 19% vs. 19%) compared to US-born and immigrants and less likely to present with visual symptoms (24% vs. 39% vs. 37%, p=0.008) respectively.
Conclusions: Differences in disease course and clinical presentation were observed by birth and migration status, which may reflect differences in ancestry. The treatment differences observed between Mexican patients compared to US-Mexicans may reflect difference in clinical practice and accessibility to treatment to each.
Disclosure: Drs. Flores, Rivas, Rito and Corona have nothing to disclose.
Drs. Amezcua, Islam and Guerrero have nothing to disclose. Ms. Palomeque has nothing to disclose.
Funding source: The USC Hispanic MS Registry is supported by the Kim Foundation (PI: L. Amezcua).