Closing the Gap for Black Patients with Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. MS causes damage to the protective layer of the nerves called the myelin sheath. Scar tissue form in the place of the damaged myelin disrupting the current of information from the brain to the body.¹ 

MS symptoms are different for each person and can shift over time. Some people have only one or two symptoms where others may have many more. Some common symptoms of MS are vision loss; muscle weakness, stiffness, spasms; bladder and bowel dysfunction; mood swings; difficulty walking and sensory changes.^1,2,3 Recent data indicates MS has a different clinical appearance in Black patients when compared to their white counterparts.  

In the past, MS appeared to be more common in white people versus other ethnic groups. As more information becomes available, data suggests that the Black population may have a higher risk and incidence of MS. It has also appeared as a more severe disease at the time of diagnosis and a more aggressive disease course leading to worse long-term outcomes and earlier mortality.⁴ This illustrates the need for more clinical data about Black patients with MS. An increased understanding of MS in this population will allow clinicians to make better, more timely and informed therapeutic choices to improve prognosis. 

Most clinical research on MS has not included a significant number of Black participants. A 2015 review showed that out of nearly 60,000 published articles about MS, only 113 focused on Black people. While they represent 13.5 percent of the U.S. population, Black people have made up only about 5% of trial participants for MS treatments, according to the National Multiple Sclerosis Society.  

The lack of information surrounding these differences has led to delays in diagnosis and therefore treatment of Black patients.⁵ For example, studies suggest that Black patients may be less responsive to disease-modifying therapies than their white counterparts, possibly because they are not started soon enough.5,6 Many factors such as genetics, environmental factors, gender and social determinants play a role in the care and treatment outcomes of MS.⁴  

In 2020, the National African Americans with Multiple Sclerosis Registry (NAAMSR) was created to identify health disparities and improve the care of Black patients with MS. NAAMSR collects information directly from the participants as opposed to physician reports. This data includes demographics, socioeconomic status, timing of symptom onset and diagnosis, drug therapies, quality of life, disability status, comorbidities, and access to care. The NAAMSR newsletter offers information on MS care, treatments, and clinical trials. NAAMSR aims to determine if there are barriers to care and suggest strategies to undo inequities of access for Black patients with MS.^1-3

Sources
^₁Demyelinating Disorders: Types, Causers, Symptoms, Treatments (webmd.com)
²MS Symptoms from A to Z - Momentum Magazine (momentummagazineonline.com)
³MS Symptoms & Signs of MS | National Multiple Sclerosis Society (nationalmssociety.org)
⁴Advancing Care and Outcomes for African American Patients with Multiple Sclerosis | Neurology
⁵How Multiple Sclerosis Affects Black People (brainandlife.org)

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