Georgetown University Hospital
Neurology

Author Of 1 Presentation

Observational Studies Poster Presentation

P0887 - Multiple sclerosis evaluation and diagnosis may be delayed in male and African American patients (ID 336)

Speakers
Presentation Number
P0887
Presentation Topic
Observational Studies

Abstract

Background

Sex and race seem to influence multiple sclerosis (MS) prognosis. Men with MS overall appear to have a worse prognosis than women with MS. Black (African American) MS patients are believed to have a worse prognosis than white MS patients. These observations suggest that men and black patients with MS may have a more aggressive disease. The possibility that delays in MS evaluation or MS diagnosis in these populations could contribute to worsened outcomes remains underexplored.

Objectives

To evaluate whether sex or race may be associated with delays in being evaluated for possible MS or in being diagnosed with MS.

Methods

We surveyed patients with a confirmed diagnosis of MS at our center in the Washington, DC region from November 2019 to March 2020, asking them to recall three events: their initial symptom onset, their first neurology visit, and their eventual MS diagnosis.

Results

Out of 101 total surveys, 94 (93.1%) were included in this analysis. 72.3% of respondents were women. Most respondents self-identified as black (N=49, 52.1%) or white (N=45, 47.9%). While there was no difference in age at symptom onset, men tended to be older than women at first neurology visit and at MS diagnosis (mean 35.9 vs 33.8 years and 39.8 vs 35.0 years, respectively). There was a trend towards longer median time from symptom onset to first neurology visit, and from first neurology visit to MS diagnosis for men (7.5 months and 2.5 months, respectively) vs. women (1 month and 1 month, respectively). The overall time from symptom onset to MS diagnosis was significantly increased for men compared to women with MS (21 months vs. 5.5 months, p=0.03). Black patients were more likely to have impaired gait at time of diagnosis than white patients (48.9% vs 28.6%, p=0.04), but there was also a trend towards longer median time from symptom onset to first neurology visit, from first neurology visit to MS diagnosis, and from symptom onset to MS diagnosis in black patients (2 months, 2 months, and 12 months, respectively) vs. white patients (1 month, 1 month, and 7 months, respectively). Black men in particular had longer median times from symptom onset to first neurology visit (12 months) and from first neurology visit to MS diagnosis (6.5 months) than other patient groups: black women (2 months and 1 month, respectively), white men (4.5 months and 1 month, respectively), and white women (1 month and 1 month, respectively).

Conclusions

There may be delays before men and black patients are evaluated for MS and before they are diagnosed with MS, compared to women and white patients. These delays in assessment and diagnosis could theoretically contribute to the observed poorer prognosis for patients of those at-risk populations.

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