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More severe disability of North Africans vs Europeans with multiple sclerosis in France

From the Department of Neurology (M.D., S.P.-V., H.V.), Central Hospital, Nancy, France; Department of Neurology (C.L., S.J.), University of Nice, France; and the Center of Clinical Epidemiology (M.D., T.R.), INSERM-DHOS CIE 6, Department of Clinical Epidemiology and Evaluation, Marin Hospital, Nancy, France.

Address correspondence and reprint requests to Dr. Marc Debouverie, Service de Neurologie, Hôpital Central, 29 Avenue Maréchal de Lattre de Tassigny, 54035 Nancy, France; e-mail: m.debouverie{at}chu-nancy.fr

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

Methods: We compared the clinical features of MS in 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.

Disclosure: The authors report no conflicts of interest.

Received April 27, 2006. Accepted in final form September 20, 2006.

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