More severe disability of North Africans vs Europeans with MS in France.

 Department of Neurology,

Central Hospital,

Nancy, France.

OBJECTIVE:

To compare the clinical disease progression in European (E) and North African (NA) patients with multiple sclerosis (MS) patients in France.

Abbreviations:

NA    =       North African

E       =       European

MS    =       Multiple Sclerosis

METHODS:

We compared the clinical features of MS inf:

211 NA patients and

2,945 E patients

in a French population-based cohort with definite MS according to McDonald's criteria.

RESULTS:

Among the NA patients with MS,

66.4% were women vs 72.9% of the E patients (p = 0.04),

15.6% had a primary progressive form of MS vs 11.7% of the E patients (p = 0.08), and the

mean age at onset was

29.9 +/- 9.8 years in the NA patients vs

32.9 +/- 10.6 years in the E patients (p < 0.0001).

In the NA patients, there was a

higher proportion of patients with incomplete recovery from the first relapse (p < 0.0001),

a shorter time between the first two relapses (p = 0.02),

a higher number of relapses in the first 5 years (p = 0.03), and

a shorter time to reach an Expanded Disability Status Scale score of 4.0 (p = 0.001) or 6.0 (p < 0.0001).

The only statistical difference in these factors between NA patients born in France and those born in North Africa was the mean age at onset of symptoms: it was earlier in NA patients born in France (p < 0.0001).

CONCLUSIONS:

The course of multiple sclerosis is more aggressive in North African than in European patients.