Floriane Calocer1, Olivier Dejardin2, Arnaud Kwiatkowski3, Bertrand Bourre4, Patrick Vermersch5, Patrick Hautecoeur6, Guy Launoy7, Gilles Defer8. 1. UNICAEN, CHU de Caen Normandie Department of Neurology, MS Expert Center, Normandie University, Caen 14000, France; Réseau Bas-Normand Pour la Prise en Charge de la SEP, Caen, France. Electronic address: floriane.calocer@outlook.fr. 2. UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandie University, Caen 14000, France. Electronic address: olivier.dejar@unicaen.fr. 3. Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille, Lille, France. Electronic address: kwiatkowski.arnaud@ghicl.net. 4. Normandie University, UNIROUEN, CHU de Rouen, Department of Neurology, Rouen University Hospital, Rouen F-76000, France. Electronic address: bertrand.bourre@chu-rouen.fr. 5. CHU Lille, LIRIC INSERM U995, FHU Imminent, University Lille, Lille F-59000, France. Electronic address: patrick.vermersch@univ-lille2.fr. 6. Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille, Lille, France. Electronic address: hautecoeur.patrick@ghicl.net. 7. UNICAEN, CHU de Caen, INSERM U1086 ANTICIPE, Pôle de Recherche, Normandie University, Caen 14000, France. Electronic address: guy.launoy@unicaen.fr. 8. UNICAEN, CHU de Caen Normandie Department of Neurology, MS Expert Center, Normandie University, Caen 14000, France; Réseau Bas-Normand Pour la Prise en Charge de la SEP, Caen, France. Electronic address: defer-gi@chu-caen.fr.
Abstract
BACKGROUND: Little is known about the association between the socioeconomic status (SES) and disability risk of patients with Multiple Sclerosis (MS). OBJECTIVE: The aim of this study was to assess the influence of low SES, otherwise known as socioeconomic deprivation, on the disability risk of MS patients. METHODS: 4498 patients with a relapsing MS disease onset between 1982 and 2017 were included from the databases of three MS expert centres (Caen, Rouen, Lille) of the French Observatory for MS (OFSEP). Sociodemographic and clinical data of 3641 patients were used for the analysis. The EDI (European Deprivation Index), an ecological and composite indicator was used to assess the level of socioeconomic deprivation. Comparisons of time to reach EDSS 4 and EDSS 6, chosen as disability milestones, according to EDI quintiles were performed by Kaplan-Meier analysis. Cox proportional hazard models were also conducted to assess the risk according to EDI quintiles with adjustment to sex, MS type and age at disease onset. RESULTS: In the study population (n = 3641), most patients were women (71.9%; n = 2664). The mean age at disease onset was 32.2 years (SD =9.7). 1684 (46%) patients reached EDSS 4 and 1005 (28%) reached EDSS 6. The risk of reaching EDSS 4 and EDSS 6 in more socioeconomically deprived patients (EDI Q5) was independently higher than in the less socioeconomically deprived patients (EDI Q1) (HR=1.37 95%CI [1.15-1.64]) to reach EDSS 4 and (HR=1.42 95%CI [1.13-1.75]) to reach EDSS 6. CONCLUSIONS: In this study, socioeconomic deprivation was significantly associated to the disability risk in MS patients. Better knowledge of socioeconomic disparities in MS may help adapt care to settings and improve the quality of care given to patients in the future.
BACKGROUND: Little is known about the association between the socioeconomic status (SES) and disability risk of patients with Multiple Sclerosis (MS). OBJECTIVE: The aim of this study was to assess the influence of low SES, otherwise known as socioeconomic deprivation, on the disability risk of MSpatients. METHODS: 4498 patients with a relapsing MS disease onset between 1982 and 2017 were included from the databases of three MS expert centres (Caen, Rouen, Lille) of the French Observatory for MS (OFSEP). Sociodemographic and clinical data of 3641 patients were used for the analysis. The EDI (European Deprivation Index), an ecological and composite indicator was used to assess the level of socioeconomic deprivation. Comparisons of time to reach EDSS 4 and EDSS 6, chosen as disability milestones, according to EDI quintiles were performed by Kaplan-Meier analysis. Cox proportional hazard models were also conducted to assess the risk according to EDI quintiles with adjustment to sex, MS type and age at disease onset. RESULTS: In the study population (n = 3641), most patients were women (71.9%; n = 2664). The mean age at disease onset was 32.2 years (SD =9.7). 1684 (46%) patients reached EDSS 4 and 1005 (28%) reached EDSS 6. The risk of reaching EDSS 4 and EDSS 6 in more socioeconomically deprived patients (EDI Q5) was independently higher than in the less socioeconomically deprived patients (EDI Q1) (HR=1.37 95%CI [1.15-1.64]) to reach EDSS 4 and (HR=1.42 95%CI [1.13-1.75]) to reach EDSS 6. CONCLUSIONS: In this study, socioeconomic deprivation was significantly associated to the disability risk in MSpatients. Better knowledge of socioeconomic disparities in MS may help adapt care to settings and improve the quality of care given to patients in the future.
Authors: Eleni S Vasileiou; Angeliki G Filippatou; Daniela Pimentel Maldonado; Grigorios Kalaitzidis; Henrik Ehrhardt; Jeffrey Lambe; Shiv Saidha; Elias S Sotirchos; Ellen M Mowry; Peter A Calabresi; Kathryn C Fitzgerald Journal: Brain Date: 2021-12-31 Impact factor: 13.501
Authors: Devi Sai Sri Kavya Boorgu; Shruthi Venkatesh; Chirag M Lakhani; Elizabeth Walker; Ines M Aguerre; Claire Riley; Chirag J Patel; Philip L De Jager; Zongqi Xia Journal: Mult Scler Relat Disord Date: 2022-06-24 Impact factor: 4.808