Impact of Race on Use of Disease-Modifying Therapy in Multiple Sclerosis

<b>Introduction:</b> Multiple sclerosis (MS) has been shown to take a more aggressive course in African American (AA) patients as compared with Caucasians. Disease modifying therapy (DMT) decreases the rate of relapses in MS, and racial differences in the use of DMT could contribute to differences in disability.<b>Methods:</b> The Knowledge Program (KP), a Cleveland Clinic electronic database linked to the Epic electronic medical record, was queried for patients aged 18-65, Caucasian or AA, with MS or clinically isolated syndrome (CIS) in whom treatment status was known. Propensity scores for likelihood of being on DMT were calculated based on multiple clinical characteristics. Subclassification and matching techniques were applied using the propensity scores, and odds ratios were calculated to determine odds of racial background between the treated and untreated patients.<b>Results:</b> A total of 4630 patients were analyzed. No significant difference in race was identified between treated and untreated patients with similar probability of being on a DMT.<b>Discussion:</b> Although compliance with treatment and other factors may play a role in the worse disability outcomes in AA patients, patient and clinician utilization of DMT prescription does not appear to play a significant role.

Name thesis:degree_name

Master of Sciences

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Clinical Research

Grantor dc:publisher

Case Western Reserve University School of Graduate Studies

Year dc:date

2013

Author dc:creator

• Hyland, Megan H.

Contributors dc:contributor

• Cohen, Jeffrey
• Love, Thomas

• Medicine
• Neurology
• Multiple sclerosis
• Treatment
• Race

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=case1355951207

OAI identifier oai:identifier

oai:etd.ohiolink.edu:case1355951207