Multiple sclerosis in US minority populations: Clinical practice insights

Abstract

The heterogeneity of multiple sclerosis (MS) characteristics among various ethnic minority populations is a topic of recent interest. However, these populations are consistently underrepresented in clinical trials, leading to limited data on the effectiveness of treatments in these groups of patients and lack of an evidence-based approach to treatment. In order to achieve optimal disease management in the ethnic minority MS populations, a better understanding of the regional, socioeconomic, and cultural influences that result in underrepresentation of these groups in clinical trials is needed. Furthermore, it would be beneficial to identify the genetic factors that influence disease disparity in these minority populations. Suggestions for the identification and implementation of best practices for fostering the trust of ethnic minority patients with MS and enhancing their participation in clinical trials are offered.

Figure. Distribution of African American and Caucasian American patients with multiple sclerosis across EDSS grades and benign and malignant categories

Box boundaries indicate the 25th and 75th quartiles, the line within each box is the median, and the 2 outer bars indicate the largest and smallest observed values that are not outliers of Expanded Disability Status Score (EDSS) differences p < 0.001. The dashed horizontal line across the 6 grades represents the expected percentage of patients in each grade (16.7%). Adapted with permission from Lippincott Williams & Wilkins/Wolters Kluwer Health: Kister I, Chamot E, Bacon JH, et al. Rapid disease course in African Americans with multiple sclerosis. Neurology 2010;75:217–223.