More severe disability of North Africans vs Europeans with multiple sclerosis in France

Objective: To compare the clinical disease progression in European (E) and North African (NA) patients with multiple sclerosis ( MS) patients in France. Methods: We compared the clinical features of MS in 211 NA patients and 2,945 E patients in a French population - based cohort with definite MS according to McDonald's criteria. Results: Among the NA patients with MS, 66.4% were women vs 72.9% of the E patients (p = 0.04), 15.6% had a primary progressive form of MS vs 11.7% of the E patients (p = 0.08), and the mean age at onset was 29.9 +/- 9.8 years in the NA patients vs 32.9 +/- 10.6 years in the E patients (p < 0.0001). In the NA patients, there was a higher proportion of patients with incomplete recovery from the first relapse (p < 0.0001), a shorter time between the first two relapses (p = 0.02), a higher number of relapses in the first 5 years (p = 0.03), and a shorter time to reach an Expanded Disability Status Scale score of 4.0 (p < 0.001) or 6.0 (p < 0.0001). The only statistical difference in these factors between NA patients born in France and those born in North Africa was the mean age at onset of symptoms: it was earlier in NA patients born in France (p < 0.0001). Conclusions: The course of multiple sclerosis is more aggressive in North African than in European patients.