Multimodal Imaging in Black and White People with Multiple Sclerosis on Ocrelizumab: A Pilot Study
Muhammad Raghib1, Fen Bao2, Eman Dannawey2, Zaima Liaquat2, Zahid Latif2, Carla Martinez2, Idan Hannawa3, Rajshi Gandhi3, David Clayton3, Ibraheem Abioye3, Jacob Rube2, Evanthia Bernitsas2
1Detroit Medical Center, 2Wayne State University, 3Genentech
Objective:
We investigated the differences in the impact of ocrelizumab on AMRIMs between black and white pwMS over a 12-month follow-up period.
Background:

Studies comparing ocrelizumab’s effects on advanced magnetic resonance imaging metrics (AMRIMs) between black and white people with multiple sclerosis (pwMS) are limited. AMRIMs, including magnetization transfer ratio (MTR), fractional anisotropy (FA), mean diffusivity (MD), and the ratio of total N-acetyl-aspartate concentration/total creatine concentration (tNAA/tCr) using proton magnetic resonance spectroscopy (1H-MRS), assess brain pathology in MS.

Design/Methods:
Twelve pwMS had brain MRIs at baseline and month 12 on a SIEMENS 3T Verio system and were started on ocrelizumab at baseline. Mann-Whitney U test in SPSS v29 was used to assess AMRIM differences between Black and White patients over 12 months, with p<0.05 as significant.
Results:

The median age of black pwMS (n=6) was 37.7 years±6.2, and white (n=6) was 46.8 years±10.5 (p=0.128).  Mean change in the MTR of normal-appearing white matter (NAWM) from baseline to month 12 was significantly different between black (-0.56%±1) and white pwMS (1.04%±0.98)  (p=0.02). On the contrary, mean change in MTR in normal-appearing grey matter (NAGM) from baseline to month 12 was non-significant, -0.4%±1.5 in black and 1.2%±1.1 in white pwMS. In MS lesions, mean MTR change in blacks was 1.7%±1.3 and whites 2.4%±1.8, the mean FA change in blacks was 0.06±0.03 and whites 0.03±0.03, and the mean MD change in blacks was -0.04 x10-3 mm2/s ±0.04 and whites -0.06 x10-3 mm2/s ±0.06. Mean change in WM tNAA/tCr from baseline to month 12 was 0.06±0.1 in blacks and 0.05±0.1 in whites. No significant difference in the mean change in FA and MD in NAGM and NAWM between the two groups.

Conclusions:

Our small sample suggests ocrelizumab may impact NAWM MTR differently in Black and White pwMS. Larger studies with extended follow-up are needed to explore potential differences in AMRIMs.

 

10.1212/WNL.0000000000211407
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