Impact of disease-modifying treatments in North African migrants with multiple sclerosis in France.
Mult Scler
; 14(7): 933-9, 2008 Aug.
Article
in En
| MEDLINE
| ID: mdl-18573824
ABSTRACT
BACKGROUND:
Multiple Sclerosis in North African migrants (MS-NA) is more aggressive with mostly primary progressive forms and cerebellar symptoms. Despite an earlier onset in NA patients, the disease progresses more rapidly, with a higher proportion showing incomplete recovery from the first relapse, a shorter time between the first two relapses, a higher number of relapses in the first 5 years, and a shorter time to reach an EDSS of 4.0 and 6.0. We collected data and studied the impact of disease-modifying therapies (DMT) in NA patients with MS, among the 4144 MS patients treated in our MS clinics.METHODS:
We performed a descriptive population-based study of MS-NA patients. Data were crossed with expected age- and gender-matched characteristics available in our EDMUS databases for the period 1995-2007.RESULTS:
A total of 133 patients, representing 66% of the MS-NA patients included in the database were identified mean age at the first documented symptom 29.7 years; mean time from diagnosis to the beginning of DMT 1.2 years. 40% of MS-NA patients had an EDSS >3 at the beginning of treatment (vs. 25%; P=0.002). A majority of patients were treated initially with immunomodulatory drugs (MS-NA 48% vs. CT 51%, P=0.8). NA patients were treated earlier after diagnosis (1.3 years vs. 4.5 years, P=0.003), with the frequent use of immunosuppressive drugs for remitting forms, mitoxantrone (18.5% vs. 7.8%, P=0.0001) and for progressive forms, cyclophosphamide (38% vs. 28%, P=0.003).CONCLUSIONS:
Considering EDSS follow-up during DMT, MS-NA patients appear as responsive as other MS patients to treatment, despite the earlier treatment prescription and the more frequent use of immunosuppressors.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Transients and Migrants
/
Multiple Sclerosis, Relapsing-Remitting
/
Immunologic Factors
/
Immunosuppressive Agents
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Africa
/
Europa
Language:
En
Journal:
Mult Scler
Journal subject:
NEUROLOGIA
Year:
2008
Document type:
Article
Affiliation country:
France