{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:04:27Z","timestamp":1789362267164,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Racial and ethnic disparities in multiple sclerosis (MS) disease-modifying therapy (DMT) use are documented but incompletely characterized across the full treatment pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using the All of Us Research Program (2024 data release) among adults aged \u226518\u202fyears with confirmed MS (\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f3,508). Outcomes included DMT initiation, time to first DMT, drug class selection, switching, escalation, and discontinuation. High-efficacy DMTs were defined as agents with \u226550% relative reduction in annualized relapse rate. Analyses were descriptive; race and ethnicity were self-reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1,564 patients (44.6%) initiated DMT. Hispanic patients had the lowest initiation rate (36.2% vs. 45.6% non-Hispanic). Black patients had the highest within-group initiation rate (49.2%) but the longest median time to first DMT (1,497\u202fdays vs. 1,217\u202fdays in White patients). High-efficacy DMT exposure ranged from 11.9 to 24.0% across race\u2013sex strata, and 76.3% of assessable initiators met the 180-day discontinuation threshold (range 71.7\u201380.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Most patients with MS in this national cohort never initiated DMT. Hispanic patients showed the lowest initiation rates, while Black patients experienced the longest delays to treatment. The two groups\u2019 patterns are consistent with mechanistically distinct barriers, possible limited system entry for Hispanic patients and possible delayed specialty access for Black patients. High-efficacy DMT utilization remained low across all groups. Equitable and timely access to DMT, including high-efficacy agents, is urgently needed to reduce long-term disability across all populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1916567","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:32:34Z","timestamp":1789360354000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Racial and ethnic disparities in disease-modifying therapy use among adults with multiple sclerosis: a real-world analysis of the All of Us Research Program"],"prefix":"10.3389","volume":"17","author":[{"given":"Victoria","family":"Font\u00e1nez-Ramos","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, San Juan Bautista School of Medicine","place":["Caguas, PR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Barreto-Nieves","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, San Juan Bautista School of Medicine","place":["Caguas, PR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grecia A.","family":"Carrasquillo-Sanabria","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, San Juan Bautista School of Medicine","place":["Caguas, PR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge F.","family":"Garc\u00eda-B\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, San Juan Bautista School of Medicine","place":["Caguas, PR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaritza","family":"Inostroza-Nieves","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, San Juan 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