Patients with multiple sclerosis (MS) who reside in a low socioeconomic neighborhood have a higher risk for disability progression, according to study results published in Neurology.
Cohorts of patients with MS from British Columbia, Canada, and South East Wales, United Kingdom, were collated from health administrative and MS clinical data. At the time of MS symptom onset (±3 years), researchers identified patients’ socioeconomic status using neighborhood-level average income. The investigators subsequently assessed the association between socioeconomic status at MS onset and confirmed Expanded Disability Status Scale (EDSS) scores with secondary disease progression. Analyses were adjusted for age at MS onset, sex, initial disease course, and disease-modifying drug exposure.
A total of 2069 patients with MS from Canada and 1044 patients with MS from Wales (N=3113) were included in the 2 cohorts. Researchers identified a correlation between higher socioeconomic status (SES) and a lower risk for achieving an EDSS score of 6.0 (adjusted hazard ratio [aHR], 0.90; 95% CI, 0.89-0.91) and 4.0 (aHR, 0.93; 95% CI, 0.88-0.98). In addition, patients with a higher SES had a lower risk for achieving secondary progression of MS (aHR, 0.94; 0.88-0.99). When researchers included all EDSS scores, the findings’ direction were similar across cohorts (generalized estimating equations: β = −0.13; 95% CI, −0.18 to −0.08).
A limitation of the analysis includes the inconsistent definition of low SES across cohorts, precluding the ability to generalize these findings across other populations.
Findings from this study indicate “that there could be an important future opportunity to positively modify health outcomes in MS by targeting aspects of SES,” the researchers concluded.
Harding KE, Wardle M, Carruthers R, et al. Socioeconomic status and disability progression in multiple sclerosis: A multinational study [published online February 22, 2019]. Neurology. doi:10.1212/WNL.0000000000007190