B-Cell-Targeted Therapies for Black vs White Americans with Relapsing Multiple Sclerosis

Objective: Given differences in disease presentation and potentially greater role of humoral immunity in Black patients with multiple sclerosis (MS) compared to White patients with MS, we analyzed the effectiveness of anti-CD20 therapies in the 2 groups of patients with relapsing MS. We included all anti-CD20 therapies and evaluated relapse rate, disability, and magnetic resonance imaging (MRI) outcomes. Methods: This is an observational study of patients with MS with baseline and follow-up data, including race, annualized relapse rates (ARRs), Expanded Disability Status Scale (EDSS) score, new T2 lesions, and B-cell repletion. This is a chart review from Weill Cornell MS database. Results: A total of 129 participants (42 Black patients with MS, 87 White patients with MS) aged 18-65 years with relapsing MS treated with anti-CD20 therapy, EDSS score ≤6.5, and ≥12 months follow-up were included in the study. There was no evidence of posttreatment ARR difference between groups (P=.696). Analysis of pretreatment data shows that at baseline, Black patients had, on average, 1.83 more relapses than White patients (95% CI, 1.14-2.92; P=.011). The percentage of patients with improved/stable/worsened EDSS score post treatment was similar in both groups. Conclusions: Black patients with MS had higher baseline disability, relapse rates, and younger age at onset Both groups treated with anti-CD20 had similar reduced higher relapse rates and radiologic progression, with faster B-cell repletion post infusion in Black patients with MS.