There are racial and ethnic differences in terms of age at certain diagnostic and treatment milestones among patients with Duchenne muscular dystrophy (DMD) in the US, found a new study published in the journal Neuroepidemiology.

The most notable differences are significant delays in 5 of 7 milestones in non-Hispanic Black patients, the study found. This, according to the authors could be due to the fact these children are evaluated and therefore diagnosed later with the disease.

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“Efforts to address barriers to early evaluation and diagnosis for non-Hispanic Black children with DMD may promote more timely initiation of recommended disease monitoring and interventions,” the researchers concluded.

It is known that there are racial and ethnic disparities in the diagnosis and treatment of many health conditions in the US leading to differences in outcomes, the authors noted. To explore whether such disparities also exist in the case of DMD, a team of researchers led by Emma Ciafaloni, MD, a professor of neurology and pediatrics at the University of Rochester Medical Center, specializing in the diagnosis and treatment of neuromuscular diseases in adults and children analyzed clinical data from 8 sites in the US from 682 boys born with DMD between 1990 and 2010. 

The researchers selected 7 milestones related to diagnosis and treatment experiences as outcomes. These included initial evaluation, first neurology/neuromuscular visit, diagnosis, time of first corticosteroid treatment offered, time of first corticosteroid treatment started, first electrocardiogram or echocardiogram, and first pulmonary function test.

They then compared the time to each milestone for non-Hispanic white, Hispanic, non-Hispanic Black, and other individuals.

They found that the initial evaluation, first neurology/neuromuscular visit, diagnosis, time of first corticosteroid treatment offered, and time of first corticosteroid treatment started occurred later for non-Hispanic Black patients compared to non-Hispanic white ones.

Moreover, the time from diagnosis to the time corticosteroids was first offered and started was longer for Hispanic patients compared to non-Hispanic white patients.

Corticosteroids are the standard of care for patients with DMD. 

Reference

Mann JR, Zhang Y, McDermott S, et al. Racial and ethnic differences in timing of diagnosis and clinical services received in Duchenne muscular dystrophy. Neuroepidemiology. Published online January 9, 2023. doi:10.1159/000528962