Background: Multiple Sclerosis in North African migrants (MS-NA) is more aggressive with mostly primary progressive forms and cerebellar symptoms. Despite an earlier onset in NA patients, the disease progresses more rapidly, with a higher proportion showing incomplete recovery from the first relapse, a shorter time between the first two relapses, a higher number of relapses in the first 5 years, and a shorter time to reach an EDSS of 4.0 and 6.0. We collected data and studied the impact of disease-modifying therapies (DMT) in NA patients with MS, among the 4144 MS patients treated in our MS clinics. Methods: We performed a descriptive population-based study of MS-NA patients. Data were crossed with expected age- and gender-matched characteristics available in our EDMUS databases for the period 1995-2007. Results: A total of 133 patients, representing 66% of the MS-NA patients included in the database were identified: mean age at the first documented symptom: 29.7 years; mean time from diagnosis to the beginning of DMT: 1.2 years. 40% of MS-NA patients had an EDSS >3 at the beginning of treatment (vs. 25%; P = 0.002). A majority of patients were treated initially with immunomodulatory drugs (MS-NA: 48% vs. CT: 51%, P = 0.8). NA patients were treated earlier after diagnosis (1.3 years vs. 4.5 years, P = 0.003), with the frequent use of immunosuppressive drugs: for remitting forms, mitoxantrone (18.5% vs. 7.8%, P = 0.0001) and for progressive forms, cyclophosphamide (38% vs. 28%, P = 0.003). Conclusions: Considering EDSS follow-up during DMT, MS-NA patients appear as responsive as other MS patients to treatment, despite the earlier treatment prescription and the more frequent use of immunosuppressors. © SAGE Publications 2008.

Immunomodulators North African migrants multiple sclerosis Immunosuppressors

descriptive research immigrant cyclophosphamide immunomodulating agent multiple sclerosis France follow up human statistics controlled study Databases, Factual factual database drug efficacy ethnology Humans liver toxicity early intervention male beta1a interferon Kaplan-Meiers Estimate female glatiramer immunologic factor risk factor Risk Factors Immunologic Factors Africa immunosuppressive agent alpha2a interferon Immunosuppressive Agents population research Multiple Sclerosis, Relapsing-Remitting mitoxantrone blood toxicity methotrexate Article major clinical study adult Africa, Northern migration drug safety North Africa outcome assessment azathioprine drug response disease severity Transients and Migrants Kaplan Meier method