Black and Hispanic patients with multiple sclerosis are underrepresented in trials, which leads to limited knowledge and understanding of the disease and treatment attributes in this population. A new study found differences among White, Black, and Hispanic patients with multiple sclerosis in terms of baseline characteristics, demographics, and disease burden.
Multiple sclerosis (MS) is an autoimmune demyelinating disease that involves the central nervous system. Retrospective U.S. studies have shown that the incidence of MS is higher in African American patients and lower in Hispanic patients compared to White patients, and the prevelance of MS is higher among African American and White patients compared to Hispanic patients.
The differences in clinical characteristics and treatment outcomes stem from health inequities and disparities that are influenced by cultural, socioeconomic, and environmental factors. Black patients with MS (BpwMS) and Hispanic patients with MS (HpwMS) are underrepresented in clinical trials and tend to have a poor disease prognosis.
This single-arm, multicenter study assessed the safety and efficacy of ocrelizumab in BpwMS and HpwMS. The study results were published in the journal Multiple Sclerosis and Related Disorders.
The clinical trials included a total of 182 patients, which comprised 69 Hispanic and 113 Black MS patients in the United States, Puerto Rico, and Kenya. The mean age of the study participants was 35.5 ± 10.5 years, and the majority (72%) of the participants were females.
Disease History and Previous Disease-Modifying Therapy
The intention-to-treat (ITT) population reported a shorter time to diagnosis and a shorter duration of disease compared to the OPERA ocrelizumab population. The baseline Expanded Disability Status Scale (EDSS) score and the prevalence of treatment-naïve individuals were relatively higher in the OPERA population.
Comparison of Brain MRI Findings
The mean number of gadolinium (Gd)-enhancing lesions on T1 imaging was relatively higher in the ITT compared to the OPERA population. The ITT population also had a greater burden of T2 lesions, with a relatively higher lesion volume. BpwMS had a higher lesion volume on T2 imaging.
Williams, M. J., Okai, A., Cross, A. H., Monson, N., Vartanian, T., Thrower, B., Reder, A. T., English, J., Wu, G. F., Bernitsas, E., Yap, S. F., Ndrio, J., Pei, J., Mowry, E. M., Magrini, F., Acosta, J. J. T., & Amezcua, L. (2023). Demographics and baseline disease characteristics of Black and Hispanic patients with multiple sclerosis in the open-label, single-arm, multicenter, phase IV CHIMES trial. Multiple Sclerosis and Related Disorders, 76, 104794. https://doi.org/10.1016/j.msard.2023.104794