Familial aggregation of multiple sclerosis: Results from the national registry of the disease in Saudi Arabia

Aljumah, Mohammed; Otaibi, Hessa Al; Towaijri, G. Al; Hassan, Ahmed; Kareem, Abid; Kalakatawi, Mamdouh H.; Al‐Rajeh, Saad; Mejally, Mousa Al; Algahtani, Hussein; Al‐Mubarak, Ali A.; Alawi, Sadaga; Qureshi, Shireen; Malik, Yaser Al; El-Metwally, Ashraf; Shami, Sahar; Ishak, Samah; Bunyan, Reem F.

doi:10.1177/2055217320960499

Cited by 12 publications

(23 citation statements)

References 32 publications

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“…6 , in each study, the first number is the number of FMS cases and the second number is the number of FMS plus sporadic cases (both in that particular gender). For instance, in the study of AlJumah et al, 107 men and 208 women with FMS and 710 men and 1440 women with sporadic MS were recruited [ 16 ]; therefore, the rate of FMS in men and women was calculated to be 107/817 (710 + 107) and 208/1648 (208 + 1440), respectively. The OR of male/female in FMS cases was not statistically significant (OR = 0.9; 95% CI: 0.6–1.2, P = 0.55) (Fig.…”

Section: Resultsmentioning

confidence: 99%

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

2021

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Background Considering that many recent studies have reported the prevalence of familial multiple sclerosis (FMS), we performed an updated meta-analysis of the worldwide prevalence of FMS by the addition of recent publications. Methods A search in PubMed, Scopus, the ISI Web of Science, and Google Scholar was undertaken up to 20 December 2020. The inclusion criteria were based on the CoCoPop approach (condition, context, and population). Meta-analysis of the qualified studies was conducted by comprehensive meta-analysis ver. 2 software. Results The pooled prevalence of MS in relatives of 16,179 FMS cases was estimated to be 11.8% (95% CI: 10.7–13) based on a random-effects model. The pooled mean age of disease onset in adult probands was calculated to be 28.7 years (95% CI: 27.2 ± 30.2). Regarding 13 studies that reported the data of FMS in pediatrics (n = 877) and adults (n = 6636), the FMS prevalence in pediatrics and adults was 15.5% (95% CI: 13.8–17.4) and 10.8% (95% CI: 8.1–14.2), respectively. The prevalence of FMS in affected males (n = 5243) and females (n = 11,503) was calculated to be 13.7% (95% CI: 10.1–18.2) and 15.4% (95% CI: 10.3–22.4), respectively. The odds ratio of male/female in FMS cases was not statistically significant (OR = 0.9; 95% CI: 0.6–1.2, P = 0.55). Subgroup analysis demonstrated a significant difference in the prevalence of FMS between the geographical areas (P = 0.007). The meta-regression model indicated that the prevalence of FMS is lower with higher latitude and higher MS prevalence (P < 0.001). In contrast, meta-regression based on prevalence day was not statistically significant (P = 0.29). Conclusions The prevalence of FMS is higher in the pediatric group than that of adults, distinct between geographical areas, and diminishes with the increment of MS prevalence and latitude. Also, the symptoms initiate relatively at younger ages in the FMS cases. Interestingly, our analysis unveiled that FMS is not more prevalent in men than women and the risk of MS development in relatives is not higher when the affected proband is male.

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Section: Resultsmentioning

confidence: 99%

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

2021

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“…In this regard, cohort studies could be well suited on the account of a longer time period for the accumulation of new cases in the family. Concerning the degree of relatedness, the occurrence of the same condition is more prevalent in rst-degree relatives, particularly siblings of the affected individuals, which underscores the combined role of shared genetic and environmental factors in MS etiology [16,24,25,29,33,34]. While, one study reported parent-child relationship as the prevalent kinship [28].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, it seems that the worldwide frequency of FMS is steady-state over time. Nonetheless, some studies in middle-east reported the increasing [13,24] or decreasing [16] prevalence of FMS over time, highlighting the existence of substantial difference in terms of genetic and environmental factors between different populations even in a same geographical area. Moreover, the overwhelming majority of the studies have been performed in a cross-sectional setting; while, su cient long follow-up period is needed to evaluate the development of the disease in new members of the relatives, primarily distant relatives that would not have been found in short-term periods.…”

Section: Discussionmentioning

confidence: 99%

“…This, in turn, lowers the load of genetic and environmental risk factors in families. On the other hand, the rate of consanguineous marriage as a predictor of positive family history of MS [16], is most probably diminished in regions with a high outbreak of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…However, it must allude that there is a discrepancy between the results of the studies. Most of them uncovered that FMS is not a different clinical entity and closely resembles sporadic MS [16,28,33,53]. Although, it appears that disease burden and progression in rst-degree relatives with the most heavily genetic load is distinct from more distant relatives [15].…”

Section: Discussionmentioning

confidence: 99%

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The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

Ehtesham

Rafie

Mosallaei

2021

Preprint

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Background: Considering that familial multiple sclerosis (FMS) can reveal the extent to which genetic and environmental factors each involve in the etiopathogenesis of the disease, we performed an updated meta-analysis of the worldwide prevalence of FMS by addition of recent publications. Methods: A search in PubMed, Scopus, the ISI Web of Science, and Google Scholar up to 20 December 2020 was done. The inclusion criteria were based on the CoCoPop approach (condition, context, and population). The qualified studies entered the process of the meta-analysis by using comprehensive meta-analysis ver. 2 software.Results: The pooled prevalence of MS in relatives of 16179 FMS cases was estimated to be 11.8% (95% CI: 10.7-13) based on a random-effects model. The pooled mean age of disease onset in adult probands was calculated to be 28.7 years (95% CI: 27.2± 30.2). In 13 studies that reported the data of FMS in pediatrics (n=6636) and adults (n=877), the FMS prevalence was 10.8% (95% CI: 8.1-14.2) and 15.5% (95% CI: 13.8-17.4), respectively. Considering the data of 9 studies, the prevalence of FMS in males (n=5243) and females (n=11503) patients was calculated to be 13.7% (95% CI: 10.1-18.2) and 15.4% (95% CI: 10.3-22.4), respectively. The odds ratio of male/female in FMS cases was not statistically significant (OR= 0.9; 95% CI: 0.6-1.2, P=0.55). Subgroup analysis demonstrated a significant difference in the prevalence of FMS between the geographical areas (P= 0.007). The meta-regression model for FMS prevalence was significantly lower in terms of higher latitude (P< 0.001) and increased MS prevalence (P< 0.001). In contrast, meta-regression based on prevalence day was not statistically significant (P=0.29).Conclusions: The prevalence of FMS is more in the pediatric group than that of adults, is distinct between geographical areas, and diminishes with the increment of MS prevalence and latitude. Also, the symptoms initiate relatively at lower ages in FMS cases. By contrast with multifactorial diseases, our analysis unveiled that the prevalence of FMS was not more prevalent in men than women and the risk of MS development in relatives was not more when the affected proband was male.

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Unmet Needs and Treatment of Relapsing-Remitting Multiple Sclerosis in Saudi Arabia: Focus on the Role of Ofatumumab

et al. 2022

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Treatment-pattern data suggest that some patients with multiple sclerosis (MS) in the Kingdom of Saudi Arabia (KSA) may not be receiving optimal treatment. A virtual meeting of ten expert Saudi neurologists, held on October 23, 2020, discussed unmet needs in relapsing–remitting MS (RRMS), and the role of ofatumumab as a suitable treatment in the KSA. Multiple unmet needs were identified: poor quality of life, with high rates of depression and anxiety; a negative impact of MS on work ability; treatment choices that may compromise efficacy for safety or vice versa; inconvenient or complex dosage regimens; and limited access to patient education and support. Early use of highly effective disease-modifying treatments (DMTs) results in better patient outcomes than starting with less effective treatments and downstream escalation, but this strategy may be underutilized in the KSA. B cells are important in MS pathogenesis, and treatments targeting these may improve clinical outcomes. Ofatumumab differs from other B cell–depleting therapies, being a fully human monoclonal antibody that binds to CD20 at a completely separate site from the epitope bound by ocrelizumab, and being administered by subcutaneous injection. When compared with teriflunomide in two randomized, phase 3 clinical trials in patients with RRMS, ofatumumab was associated with significant reductions in annualized relapse rates, rates of confirmed disability worsening, and active lesions on magnetic resonance imaging. The incidence of adverse events, including serious infections, was similar with the two treatments. Ofatumumab is a valuable first- or second-line treatment option for RRMS in the KSA, particularly for patients who would benefit from highly effective DMTs early in the disease course, and for those who prefer the convenience of self-injection. Future research will clarify the position of ofatumumab in RRMS treatment, and comparative cost data may support the broad inclusion of ofatumumab in formularies across the KSA.

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Familial aggregation of multiple sclerosis: Results from the national registry of the disease in Saudi Arabia

Cited by 12 publications

References 32 publications

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

Unmet Needs and Treatment of Relapsing-Remitting Multiple Sclerosis in Saudi Arabia: Focus on the Role of Ofatumumab

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