Incidence of MS has increased markedly over six decades in Denmark particularly with late onset and in women

Koch‐Henriksen, Nils; Thygesen, Lau Caspar; Stenager, Egon; Laursen, Bjarne; Magyari, Melinda

doi:10.1212/wnl.0000000000005612

Cited by 140 publications

(113 citation statements)

References 42 publications

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“…In line with previous studies . an increasing female preponderance was also reported by a more recent epidemiological study from Denmark: female incidence did not only increase generally in MS, but more pronounced in patients with late disease onset . However, differences in female preponderance between CIS, RRMS, and PPMS had not been investigated.…”

Section: Discussionsupporting

confidence: 84%

“…15,16 an increasing female preponderance was also reported by a more recent epidemiological study from Denmark: female incidence did not only increase generally in MS, but more pronounced in patients with late disease onset. 18 However, differences in female preponderance between CIS, RRMS, and PPMS had not been investigated. As demonstrated in our patient cohort, PPMS patients were older and had a slight male preponderance, which is also supported by other cohort studies.…”

Section: Discussionmentioning

confidence: 99%

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Age‐dependent variation of female preponderance across different phenotypes of multiple sclerosis: A retrospective cross‐sectional study

et al. 2018

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Summary Introduction Multiple sclerosis (MS) is an autoimmune disease of the CNS, which predominantly affects women. Studies investigating the sex distribution in MS are sparse. We aim to analyze the female‐to‐male ratio (F/M ratio) in different MS phenotypes in association with age at diagnosis and year of birth. Methods We performed a retrospective cross‐sectional analysis by cumulating data (sex, year of birth, age at diagnosis, and MS phenotypes) from unpublished and published studies of the participating centers. Results Datasets of 945 patients were collected. The overall F/M ratio was 1.9:1.0 and female preponderance was present in all phenotypes except for primary progressive MS (PPMS), in which men were predominantly affected (F/M ratio: 0.5:1.0). Female preponderance declined with increasing age at diagnosis and was no longer present in relapsing‐remitting MS (RRMS) patients > 58 years of age. Conclusion Our data demonstrate an age dependency of female preponderance in MS except for PPMS. This could be influenced by the lifecycle of sex hormone secretion in women. In PPMS, a male preponderance was observed in all age‐groups, which might point to pathophysiological mechanisms being less influenced by sex hormones.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Age‐dependent variation of female preponderance across different phenotypes of multiple sclerosis: A retrospective cross‐sectional study

et al. 2018

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“…Epidemiological observations in multiple sclerosis (MS) have consistently pointed at globally increasing prevalence . At the same time, MS mortality has decreased, and analyses on incidence have shown both stability and increase . The highest age‐standardized estimates have been observed in northern latitudes where prevalence among women and in relapsing‐remitting MS is high.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 At the same time, MS mortality has decreased, and analyses on incidence have shown both stability and increase. [2][3][4][5] The highest age-standardized estimates have been observed in northern latitudes where prevalence among women and in relapsing-remitting MS is high. The relationship between socioeconomic determinants and increase in MS occurrence is observed, occurrence being higher in areas of higher socioeconomic level.…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis prevalence in 2000 and 2010 in Western Finland

Murtonen

Sumelahti

2020

Acta Neurol Scand

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Objective To study ten‐year change in MS prevalence in the Province of Western Finland in Tampere University Hospital District located in 62.7°N, 23.7°E. Methods Age‐standardized prevalence/105 by using direct standardization in European Standard Population (ESP2013) and crude prevalence/105 with 95% confidence interval (95% CI) were assessed among resident MS cases fulfilling Poser criteria by sex and disease course in 31.12.2000 and 31.12.2010. MS‐related disability and disease‐modifying treatment (DMT) use were estimated in 31.12.2010. Results Crude prevalence increased 49% from 129/105 (95% CI 121‐137) in 2000 (N 1080) to 196/105 (187‐203) in 2010 (N 1666). Age‐standardized prevalence increased 45% from 133/105 (127‐140) to 192/105 (184‐200) and peaked in 40‐ to 49‐year age‐group. Age‐standardized prevalence increased 58% among women from 176/105 (171‐176) to 277/105 (270‐284) and 31% among men from 91/105 (87‐95) to 119/105 (115‐124). Increase in RRMS was 61% from 111/105 (105‐117) to 179/105 (171‐186), and decrease in PPMS was 14% from 21/105 (19‐24) to 18/105 (15‐21). In 2010 among the 52% RRMS cases on DMT, MS‐related disability was mild in 50%. In total, cohort disability was mild in 46%, moderate to severe in 47%, and information was not available in 14%. Conclusion A significant increase in prevalence was observed in Western Finland. Increase was higher among women and in relapsing‐remitting onset MS. Disability showed age‐ and disease course‐specific variation.

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“…The number of MS cases with ON or TM was surprisingly low, with approximately 1.9% (300/15848) of patients alive (Papp et al, ). The incidence rate for MS in Denmark is estimated to be 12.3 per 100,000 in women and 6.1 per 100,000 in men (Koch‐Henriksen, Thygesen, Stenager, Laursen, & Magyari, ). ON is a frequent early inflammatory demyelinating event of MS and NMOSD, and 50%–60% of MS patients and 90% of NMOSD patients will have at least one episode of ON during the course of disease (Matiello et al, ; de Seze et al, ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of neuromyelitis optica spectrum disorder in Denmark (1998–2008, 2007–2014)

et al. 2019

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Epidemiological studies of the uncommon disorder neuromyelitis optica spectrum disorder (NMOSD) may be difficult to interpret because of the evolving nature of diagnostic criteria, differences in the definition and accuracy of NMOSD diagnosis, the completeness of case ascertainment, and variability in assays for the disease‐specific biomarker aquaporin‐4 (AQP4)‐IgG. A sub‐group of patients with the clinical syndrome NMOSD lack detectable AQP4‐IgG and in these cases an accurate diagnosis requires precise diagnostic algorithms and longitudinal follow‐up. Consecutive sets of criteria for NMO/NMOSD have been introduced during the two last decades. Such criteria need validation in different populations. Detection of other autoantibodies, such as IgG specific for myelin oligodendrocyte glycoprotein or for glial fibrillary acidic protein in a sub‐group of AQP4‐IgG–negative NMOSD patients, has improved over the past decade and may lead to overlap of the clinical syndromes/phenotypes. This review begins by summarizing current knowledge on the widening clinical spectrum of NMOSD. Subsequently, we describe two epidemiological studies from Denmark carried out in two different decades (1998–2008 and 2007–2014) and comment on the differences in study design, patient ascertainment, and interpretation of results. These factors may explain some of the observed differences, reflecting the complexity and providing a clear example of this development.

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Incidence of MS has increased markedly over six decades in Denmark particularly with late onset and in women

Abstract: The incidence of MS has doubled in women, most pronounced with late onset, and has only modestly increased in men. Lifestyle changes in the female population that could include fewer childbirths, increased occurrence of obesity, and increased cigarette consumption may have a role.

Cited by 140 publications

References 42 publications

Age‐dependent variation of female preponderance across different phenotypes of multiple sclerosis: A retrospective cross‐sectional study

Age‐dependent variation of female preponderance across different phenotypes of multiple sclerosis: A retrospective cross‐sectional study

Multiple sclerosis prevalence in 2000 and 2010 in Western Finland

Epidemiology of neuromyelitis optica spectrum disorder in Denmark (1998–2008, 2007–2014)

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