New Treatment Approach Aims to Close Gap for MS Patients of Color

A recent study unveils a promising intervention to address the treatment disparities faced by Hispanic and Black individuals diagnosed with multiple sclerosis (MS). Conducted by Dr. Annette Langer-Gould and her research team at Kaiser Permanente Southern California, this study introduces a straightforward treatment algorithm designed to guide healthcare professionals in prescribing disease-modifying therapies for MS.

Multiple sclerosis, a chronic disease affecting the central nervous system, presents varying symptoms and progression among patients. However, research has indicated alarming disparities in treatment access and effectiveness linked to race and ethnicity. Historically, Hispanic and Black patients have been found to experience greater levels of disability and have often been under-prescribed newer, more effective treatments compared to their white counterparts.

The innovative algorithm proposed in this study leverages easily obtainable clinical factors such as physical weakness and bladder dysfunction, while also factoring in social determinants of health like cost, transportation access, childcare responsibilities, and work schedules. Notably, the algorithm does not factor in race or ethnicity, aiming instead to create equal conditions for all patients seeking treatment.

During the study, involving 1,741 Hispanic patients, 978 Black patients, and 3,400 white patients with MS, researchers analyzed treatment patterns over a 12-year period. Findings revealed that prior to the initiation of the algorithm, Hispanic individuals recorded a higher annual relapse rate (245 relapses per 1,000 person-years) compared to white individuals (156 relapses per 1,000 person-years). Furthermore, Black patients also demonstrated a higher relapse rate during the initial phases of the study.

Following the implementation of the treatment algorithm, a significant increase in the prescribing of highly effective therapies was observed. Specifically, Hispanic patients exhibited an 89% increase in the utilization of advanced treatments, while Black and white patients showed 87% and 83% increases, respectively. The remarkable uptake of these therapies has led to a notable decline in annual relapse rates, with reductions of 90% for Hispanic patients, 86% for white patients, and 82% for Black patients.

By the conclusion of the study, the disparity in annual relapse rates among different racial and ethnic groups had been virtually eliminated, showcasing the effectiveness of a standardized approach in bridging treatment gaps.

Dr. Langer-Gould expressed optimism regarding the algorithm’s potential to increase access to effective medications, emphasizing the importance of affordability and accessibility in mitigating health disparities. The focus on medications such as rituximab, which offers cost-effective treatment options with less frequent dosing, plays a vital role in this initiative.

While the results are promising, the study is not without limitations. It did not assess long-term disability outcomes or investigate whether initiating treatment with highly effective therapies from the point of diagnosis is more advantageous than delaying treatment until later in the disease course.

As the research community continues to explore avenues for improving health equity in the treatment of chronic conditions like multiple sclerosis, this study provides a foundational insight into how algorithm-based strategies can facilitate better health outcomes for underserved populations. The findings will be presented at the American Academy of Neurology's 77th Annual Meeting, scheduled for April 5–9, 2025, in San Diego and online, contributing to ongoing discussions about reducing health inequities in medicine.

To stay informed about multiple sclerosis and other neurological conditions, visit BrainandLife.org, a patient-focused resource from the American Academy of Neurology, which provides comprehensive information on brain health and connects individuals impacted by neurological disorders with leading experts in the field.