Multiple Sclerosis Onset Begins Significantly Earlier in Latinx Patients

Daniel Ontaneda, MD, PhD

Findings from a retrospective, cross-sectional study using data collected from the MS PATHS network revealed minimal differences between Latinx and non-Latinx patients with multiple sclerosis (MS), except for the fact that disease onset occurred 5 years earlier for Latinx individuals.

These data were presented at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 31 to June 3, in Aurora, Colorado, by senior investigator Daniel Ontaneda, MD, PhD, associate professor of neurology, Cleveland Clinic Lerner College of Medicine of Case Western University. In addition the younger onset, results also suggested specific race/ethnicities may differentially present with clinically isolated syndrome (CIS) or progressive phenotypes.

The analysis included 3335 individuals diagnosed with MS from 2010 to 2020, aged 18 years or older, with an average disease duration of 10.2 years. Of those diagnosed, 3089 (92.6%) were White non-Latinx patients and 247 (7.4%) were Latinx persons (White Latinx: 2.9%; non-White Latinx: 4.5%). The 2 groups did not differ in terms of proportion of female patients (Latinx: 75%; non-Latinx: 70%) and ever-smokers (43% vs 45%); although, Latinx individuals reported less education than White non-Latinx persons (14.3 vs 15 years; P rank sum = 1.3 x 10-5).

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Multivariable multinomial logistic regression models were conducted for age at onset (AAO) with ethnicity as the key predictor, adjusting for diagnosis year, sex, ever smoker, education, and disease course. When adjusting for covariates, AAO of MS was significantly earlier for Latinx patients, by an average of 4.8 years (SD, 0.4; P = 1.3 x 10-5) than White non-Latinx persons. Results persisted when restricting to disease duration less than or equal to 10 years.

MS course at onset did not differ between Latinx persons and White non-Latinx persons (relapsing: 78.1 vs 78.8%; progressive 15.0 vs 16.6%; CIS: 6.2 vs 5.3%) in unadjusted and adjusted models; however, adjusted models suggested that White Latinx individuals more likely to present with progressive disease (OR, 1.5; P = .008) compared with White non-Latinx persons.

Earlier this year, at the 2023 American Academy of Neurology Annual Meeting, Ontaneda presented additional data from MS PATHS highlighting different clinical courses in Latinx patients with MS. Despite being younger (45.4 vs 52.9 years; P <.001) and shorter disease duration (17.2 vs 19.5 years; P <.001), Latinx patients showed a higher T2 lesion volume (8.0 ml vs 6.5 ml; P = .009) and lower thalamic volume (12.8 ml vs 13.3 ml; P <.001) compared with White individuals. Adjusted mixed models showed that Latinx patients had lower processing speed, brain parenchymal fraction, thalamic volume, cortical volume, and deep gray matter volume (all P <.001) as well as slower walking speed (P = .004), non-dominant manual dexterity (P <.01), and higher patient-determined disease steps (P = .045).²

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REFERENCES
1. Briggs FBS, Harvey T, Fitzgerald KC, Mowry EM, Cohen JA, Ontaneda D. Latinx with multiple sclerosis have an earlier onset. Presented at: 2023 CMSC Annual Meeting; May 31-June 3; Aurora, CO. DMX04.
2. Ontaneda D, Cohen JA, Mowry EM, et al. Latinx with multiple sclerosis have greater disability and loss of deep and cortical gray matter. Presented at: 2023 AAN Annual Meeting; April 22-27; Abstract S31