背景:白人和黑人人群之间MS病程的差异已被广泛接受。明尼苏达州有大量的索马里移民人口,这有助于研究该移民非洲原住民的MS特征。这项研究的目的是比较索马里裔美国人(SA),非洲裔美国人(AA),以及患有MS(pwMS)的美国白人(WA)患者的临床特征和疾病修饰治疗(DMT)的使用。
方法:这项单中心(梅奥诊所)地理限制的回顾性队列研究(位于罗切斯特250英里范围内,MN,美国)包括2023年5月之前看到的参与者。美国移民年龄;MS发病年龄;DMT使用/类型;MS阶段/表型;进行性MS(PMS)发病年龄;以及重度MS(扩展残疾状态量表-EDSS≥6)的比例。
结果:18SApwMS,92AApwMS,包括94个WApwMS。在15名非美国出生的SApwMS中,3/15青春期前移民,3/15青春期,8/15青春期后,和1/15在一个未知的日期。SApwMS在MS发病时更年轻(中位年龄,四分位数间距(IQR)=25,22-33vs.AApwMS:31,25-38;p=0.049vs.WApwMS:35,27-41;p=0.022)。DMT使用频率为13/19SApwMS,69/92AApwMS,80/94WApwMS(p>0.05)。SApwMS早于AApwMS(HR2.16,p=0.012)和WApwMS(HR1.86,p=0.041)用DMT处理。SApwMS不太常用那他珠单抗治疗(SApwMS0%,AApwMS13%,WApwMS25%;p=0.035)和抗CD20治疗(SApwMS23%,AApwMS23%,WApwMS48%;p=0.005)。PMS发生在3/19SApwMS,28/92AApwMS和29/94WApwMS(p>0.05)。SApwMS的PMS发病年龄(47岁,34-57)类似于WApwMS(47年,31-71;p>0.05),但比AApwMS(41岁,18-7;p=0.008)。
结论:最近移民到美国的SApwMS与WApwMS的病程相似,并且比来自同一地理区域的AApwMS更好。
BACKGROUND: Differences in the MS course between White and Black populations is well accepted. The existence of a large Somali immigrant population in Minnesota facilitates a study of MS characteristics in this immigrant native African population. The objective of this study was to compare Somali American (SA), African American (AA), and White American (WA) persons with MS (pwMS) regarding clinical features and disease modifying therapy (DMT) use.
METHODS: This single center (Mayo Clinic) geographically-restricted retrospective cohort study (residing within 250 miles of Rochester, MN, USA) included participants seen before May 2023. Age at immigration to the USA; age at MS onset; DMT use/type; MS phase/phenotype; age at progressive MS (PMS) onset; and proportion with severe MS (expanded disability status scale-EDSS ≥6) were examined.
RESULTS: 18 SApwMS, 92 AApwMS, and 94 WApwMS were included. Of the 15 SApwMS not born in USA, 3/15 immigrated pre-puberty, 3/15 peri‑puberty, 8/15 post-puberty, and 1/15 at an unknown date. SApwMS were younger at MS onset (median years, interquartile range (IQR)=25, 22-33 vs. AApwMS: 31, 25-38; p = 0.049 vs. WApwMS: 35, 27-41; p = 0.022). DMT use frequencies were 13/19 SApwMS, 69/92 AApwMS, 80/94 WApwMS (p > 0.05). SApwMS were treated with DMT earlier than AApwMS (HR 2.16, p = 0.012) and WApwMS (HR 1.86, p = 0.041). SApwMS were less commonly treated with natalizumab (SApwMS 0 %, AApwMS 13 %, WApwMS 25 %; p = 0.035) and anti-CD20 therapies (SApwMS 23 %, AApwMS 23 %, WApwMS 48 %; p = 0.005). PMS occurred in 3/19 SApwMS, 28/92 AApwMS and 29/94 WApwMS (p > 0.05). Age of PMS onset in SApwMS (47 years, 34-57) was similar to WApwMS (47 years, 31-71; p > 0.05) but older than AApwMS (41 years, 18-7; p = 0.008).
CONCLUSIONS: SApwMS that recently immigrated to the USA have similar disease course to WApwMS, and better than AApwMS from the same geographical region.