Ethnic differences in the incidence of Amyotrophic Lateral Sclerosis: A meta-analysis of population-based studies (P4.151)

Objective: To assess the variability in the incidence of Amyotrophic Lateral Sclerosis (ALS) in different ethnic groups. Background: ALS is a rare neurodegenerative disorder with a high personal, societal and economic burden. Whether ALS incidence varies with ethnicity is of major interest. Methods: We performed a systematic review and meta-analysis of data concerning the differences in incidence of ALS as regard ethnicity. Random effect meta-regression was conducted. Both crude and 2010 US gender and age-standardized incidence were considered. Sub-continent was used as a proxy for ethnicity. We also relied on data from public genomic databases. Results: We reviewed 3058 records. 78 population-based studies were selected, covering 40 geographical areas in 10 sub-continents. A total of 11643 ALS cases and 737 million PYFU were considered. The overall pooled worldwide crude incidence of ALS was at 1.78 (1.55-2.01)/100,000 PYFU; 1.72 (1.51-1.93) after standardization on the 2010 US population. Significant differences have been reported between Europe and East Asia (China, Japan), Central Asia (Iran) and West Asia (Israel). Conversely, homogeneous rates have been reported in Caucasian populations from Europe, North America and New Zealand. A more refined approach, involving genomic data, confirmed the positive association between ALS incidence and European ancestry (pooled USA standardized incidence: 1.85 (1.68-2.02) for populations with European ancestry 蠅80[percnt]) and the negative association between ALS incidence and admixed populations or Asian ancestry (pooled USA standardized incidence: 0.83 (0.41-1.24) for populations with Asian ancestry 蠅80[percnt]). Discussion: This review sets the scene to sustain a collaborative study involving a wide international consortium in order to perform, with homogeneous methodology, an investigation of the link between ancestry, environment, and ALS incidence. Disclosure: Dr. marin has nothing to disclose. Dr. Farid has nothing to disclose. Dr. Logroscino has received personal compensation for activities with Novartis, GlaxoSmithKline, and Boerhinger, and as a member of the Cohorts Project in Biomedicine. Dr. Logroscino has received personal compensation in an editorial capacity for Karger. Dr. Marie Claude has nothing to disclose. Dr. Anne Louise has nothing to disclose. Dr. Preux has nothing to disclose. Dr. Beghi has received personal compensation for activities with GlaxoSmithKline, UCB Pharma, and ViroPharma.