Incapacidade e progressão em pacientes afrodescendentes com esclerose múltipla

Aurenção, Juliana Calvet Kallenbach; Vasconcelos, Claudia Cristina Ferreira; Thuler, Luiz Claudio Santos; Alvarenga, Regina Maria Papais

doi:10.1590/0004-282X20160118

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VIEWS AND REVIEWS • Arq. Neuro-Psiquiatr. 74 (10) • Out 2016 • https://doi.org/10.1590/0004-282X20160118 copiar

Incapacidade e progressão em pacientes afrodescendentes com esclerose múltipla

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

A prevalência da esclerose múltipla (EM) é maior em populações caucasianas (CA), o que limita a análise do impacto da Afrodescendencia (AD) nos desfechos da doença. Apesar disto, estudos recentes observaram que a AD determina um curso clínico mais severo. O principal objetivo deste estudo é confirmar e discutir, por meio de uma revisão sistemática, que a afrodescendência é um fator de risco para acúmulo de incapacidade e/ou progressão mais severa em pacientes com EM. Foi realizada uma revisão sistemática de trabalhos publicados nos últimos onze anos que avaliaram aspectos clínicos e incapacidade a longo prazo em pacientes com EM. Quatorze artigos foram incluídos. Entre eles, treze observaram uma relação entre AD e pior prognóstico da EM. AD é uma condição inerente ao paciente e deveria ser considerada, assim como as características clínicas relacionadas ao prognóstico, influenciando a decisão terapêutica a ser tomada nas fases iniciais da doença.

esclerose múltipla; progressão da doença; incapacidade, afrodescendente

Author,y.	AD (n; %) in the cohort	Results concerning AD population (compared to CA)
Kaufman et al. 2003²⁶	95; 12.9	Higher EDSS mean after 4 years of disease and shorter time to progression
Cree et al. 2004¹⁵	375; 46.7	Shorter time to progression and EDSS 6 and 7
Naismith et al. 2006²³	79; 49.7	Higher EDSS mean at diagnosis and after 4 and 6 years of follow up
Debouverie et al. 2007²²	211; 6.7	Shorter time to EDSS 4 and 6
Weinstock-Guttman et al. 2008¹⁶	329; 5.9	Higher EDSS mean after 5, 10, 15 and 20 years of disease
Vasconcelos et al. 2010²⁹	23; 35.4	Shorter time to EDSS 3, 6 and 8
Vasconcelos et al. 2012²⁸	33; 22.0	Shorter time to progression and higher EDSS median after 5 and 10 years of follow up
Koffman et al. 2013²⁷	43; 50.0	Shorter time to EDSS 4, 6, 8 and progression

Author, y.	AD (n; %) in the cohort	Results concerning AD population (compared to CA)
Kaufman et al. 2003²⁶	95; 12.9	Had advanced age at onset and shorter disease duration than CA
Buchanan et al. 2004²⁴	1367; 12.8	Were admitted to nursing home younger; more frequency of AD with worse cognitive performance; were less independent in ADL Long Form Scale
Cree et al. 2004¹⁵	375; 46.7	Were older at onset and had shorter disease duration, had early diagnosis and early treatment and had more polysymptomatic relapses
Buchanan et al. 2006²⁵	461; 11.3	Were admitted to nursing home younger; more frequency of AD with worse cognitive performance; were less independent in ADL Long Form Scale
Naismith et al. 2006²³	79; 49.7	Had a higher frequency of progressive forms, ataxia, tremor and cognitive dysfunction; Lower frequency of benign forms among ADs
Marrie et al. 2006²¹	1017; 4.7	Early diagnosis and shorter disease duration; PDDS median was higher
Debouverie et al. 2007²²	211; 6.7	Younger age at onset and shorter mean of follow up; had more frequently incomplete recovery from the first relapse, shorter time interval between first and second relapse and higher number of relapses in the first five years of the disease
Weinstock-Guttman et al. 2008¹⁶	329; 5.9	Were diagnosed younger; cognitive impairment was more frequent
Kister et al. 2010²⁰	419; 6.7	Shorter disease duration at diagnose; lower AD frequency of benign form; higher AD frequency of malignant form; higher median MSSS
Vasconcelos et al. 2010²⁹	23; 35.4	Men predominant in AD group and ADs had shorter disease duration
Buchanan et al. 2010¹⁷	1313; 4.6	Mean age at NARCOMS enrolment was lower among AD. ADs had shorter disease duration, had severe gait disability, fatigue, bowel and bladder incontinence, spasticity, visual and cognitive impairment, depression, tremor and loss of coordination than CAs; were more frequent represented at higher PDDS scores
Vasconcelos et al. 2012²⁸	33; 22.0	Older at disease onset; more incomplete recovery and higher number of relapses; benign form less frequent in AD; malignant form more frequent in AD
Koffman et al. 2013²⁷	43; 50.0	More cognitive impairment; MSSS mean was higher

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[1] Correspondence: Juliana Calvet Kallenbach Aurenção; Rua Mariz e Barros 775 / 2° andar; 20270-004 Rio de Janeiro RJ, Brasil; E-mail: julianacka@hotmail.com