Fast multiple sclerosis progression in North Africans

Sidhom, Youssef; Maillart, Élisabeth; Montcel, Sophie Tezenas du; Kacem, Imen; Lubetzki, Catherine; Gouider, Riadh; Papeix, Caroline

doi:10.1212/wnl.0000000000003762

Cited by 26 publications

(16 citation statements)

References 31 publications

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“…One recent French study assessed the phenotype of MS among NA living in France, NA living in Tunisia and French patients of European origin [ 31 ]. They highlighted a difference in progressing to EDSS 6 between NA and European patients, and found significantly shorter times to reach EDSS 3, 4 and 6 in NAG2 patients living in France in comparison with Europeans.…”

Section: Discussionmentioning

confidence: 99%

Generational changes in multiple sclerosis phenotype in North African immigrants in France: A population-based observational study

et al. 2018

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BackgroundThe incidence of multiple sclerosis (MS) changes from generation to generation in ethnically different immigrants compared with native-born people. We aimed to determine whether there are generational changes in MS phenotypes among North African immigrants in France.MethodsCohort study with data from a population-based MS registry to compare the clinical characteristics of 80 first (NAG1) and 167 second (NAG2) generation North Africans with MS living in France with 5200 native-born Europeans. Adjusted Cox models were used to test the association between scores of 3 and 6 on the expanded disability status scale (EDSS) and the “origin/generation” variable.ResultsCox models for EDSS scores 3 and 6 showed a higher risk of score 3 (hazard ratio = 1.738, 95% confidence interval 1.237 to 2.444; P = .002) and 6 (hazard ratio = 2.372, 95% confidence interval 1.626 to 3.462; P<.0001) for NAG1 than Europeans. Being NAG2 was not significantly associated with higher hazards of scores 3 and 6.ConclusionsWe found two different phenotypes among NAG1 and NAG2 MS patients in France. NAG1, but not NAG2, have a higher risk of disability than Europeans. This raises the question of environmental factors in MS expression, and advocates appropriate patient management according to generation in immigrants.

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Section: Discussionmentioning

confidence: 99%

Generational changes in multiple sclerosis phenotype in North African immigrants in France: A population-based observational study

et al. 2018

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“…Our patients with RRMS reached an EDSS score of 6.0 after a median time of 15.7 years, which is much shorter than what has been described in Western MS populations. Median time to EDSS 6.0 in RRMS patients was 21 (19–24) and 27.3 (16.3–39.7) years in two French studies, 34,35 and 30.3 (28.6–32.0) years in British Columbia. 32 Similar conclusions were reached by two French studies comparing disability progression between Caucasian French, French of North African origin and Tunisian RRMS patients.…”

Section: Clinical Characteristicsmentioning

confidence: 96%

Epidemiology and phenotypes of multiple sclerosis in the Middle East North Africa (MENA) region

Yamout

Assaad

Tamim

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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The Middle East North Africa (MENA) region falls in the low-to-moderate multiple sclerosis (MS) prevalence zone, with prevalence rates slightly lower than Southern Europe but much higher than sub-Saharan Africa. However, there is clearly a trend toward increased MS prevalence over the last few decades, consistent with the globally rising prevalence of the disease. We analyzed all data collected from the MENACTRIMS (Middle East North Africa Committee for Treatment and Research in Multiple Sclerosis) registry by the end of December 2018. A total of 6885 patients were eligible for the study. Overall, the clinical phenotype of MS in the MENA region was not different from the Western phenotype except for earlier age at onset and a more aggressive clinical course leading to earlier disability.

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“…Other studies have reported similar trends in severity [ 17 , 18 ], and Sidhom et al . highlighted that the higher severity in North Africans is independent of patient location (within or outside Africa) [ 19 ], which suggests a genetically driven explanation. Kissani also shared the results of a questionnaire he sent to his African colleagues—in an attempt to understand the true prevalence of MS in African countries—highlighting not only the low number of MS cases reported, but also the comparably high incidence of neuromyelitis optica (NMO) and the problematic lack of resources and therapies (in most cases, the only treatments available were corticosteroids).…”

Section: Epidemiology and Recent Advancesmentioning

confidence: 99%

State of the Art and Future Challenges in Multiple Sclerosis Research and Medical Management: An Insight into the 5th International Porto Congress of Multiple Sclerosis

et al. 2020

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The 5th International Porto Congress of Multiple Sclerosis took place between the 14th and 16th of February 2019 in Porto, Portugal. Its intensive programme covered a wide-range of themes-including many of the hot topics, challenges, pitfalls and yet unmet needs in the field of multiple sclerosis (MS)-led by a number of well-acknowledged world experts. This meeting review summarizes the talks that took place during the congress, which focussed on issues in MS as diverse as the development and challenges of progressive MS, epidemiology, differential diagnosis, medical management, molecular research and imaging tools.

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Fast multiple sclerosis progression in North Africans

Abstract: Our study further supports severity of MS in NAs and unravels the particular severity in NAs living in France, mainly for the second generation.

Cited by 26 publications

References 31 publications

Generational changes in multiple sclerosis phenotype in North African immigrants in France: A population-based observational study

Generational changes in multiple sclerosis phenotype in North African immigrants in France: A population-based observational study

Epidemiology and phenotypes of multiple sclerosis in the Middle East North Africa (MENA) region

State of the Art and Future Challenges in Multiple Sclerosis Research and Medical Management: An Insight into the 5th International Porto Congress of Multiple Sclerosis

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