Increased prevalence, incidence, and female predominance of multiple sclerosis in northern Japan

Houzen, Hideki; Niino, Masaaki; Hirotani, Makoto; Fukazawa, Toshiyuki; Kikuchi, Seiji; Tanaka, Keiko; Sasaki, Hidenao

doi:10.1016/j.jns.2012.08.032

Cited by 97 publications

(91 citation statements)

References 32 publications

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“…East Asia Japan According to our review, a large increase in prevalence was observed during the last decade from 7.7 in 2003 in the Tokachi province of Hokkaido in Northern Japan to 13.1 in 2006 and 16.2 in 2011 respectively in the same area [17,18] . Several national surveys on MS were performed in Japan in 1972, 1982, 1989, and 2004 [19, 26, 85] ; the 2004 survey was carried out by the Research Committees of Epidemiology of Intractable Diseases and Neuroimmunological Diseases.…”

Section: Data Extraction and Quality Assessmentmentioning

confidence: 82%

“…Some Asian countries, including Iran and Japan, have reported an increased prevalence of MS in the last decade [17,66] .…”

Section: Discussionmentioning

confidence: 99%

“…The mean age at disease onset had decreased from 33 ± 13 in 1972 to 28.3 in 2011. In Japan, certain explanations for a decline in the mean age include more frequent utilization of MRI imaging as well as improved neurological care [17] . China Cheng et al [33] reported the MS prevalence of 1.39 per 100,000 (95% CI 1.16-1.66) in Shanghai.…”

Section: Data Extraction and Quality Assessmentmentioning

confidence: 99%

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Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review

Eskandarieh

Heydarpour²,

Minagar³

et al. 2016

Neuroepidemiology

123

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Background: Multiple sclerosis (MS) is one of the most common chronic immune-mediated diseases of the human central nervous system and an important cause of non-traumatic neurologic disability among young population in several countries. Recent reports from East Asia, South East Asia and South Asia have proposed a low to moderate prevalence of MS in these countries. Methods: A literature review search was carried out in December 2014 in Medline, Embase, Scopus and Cochrane library to recover original population-based studies on MS epidemiology in East Asia, South East Asia and South Asia countries published between January 1, 1950 and December 30, 2014. We intended search strategies using the key words: multiple sclerosis, prevalence, incidence and epidemiology. Based on our inclusion criteria, 68 epidemiologic studies were included in this systematic review. Results: The most extensively used diagnostic criteria in the studies were McDonald's criteria. Most studies were performed in a multi-center hospital setting. The female to male ratio varied and ranged from 0.7 in India to 9.0 in China. The mean age at disease onset ranged from the lowest age of 25.3 in Iran to the highest age of 46.4 in China. MS prevalence ranged from 0.77 in 100,000 populations in Hong Kong (1999) to 85.80 in 100,000 in Iran (2013). Conclusions: Advances in MS registries around the globe allow nationwide population-based studies and will allow worldly comparisons between the prevalence and incidence in different regions that are provided to monitor estimation.

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Section: Data Extraction and Quality Assessmentmentioning

confidence: 82%

“…Some Asian countries, including Iran and Japan, have reported an increased prevalence of MS in the last decade [17,66] .…”

Section: Discussionmentioning

confidence: 99%

Section: Data Extraction and Quality Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review

Eskandarieh

Heydarpour²,

Minagar³

et al. 2016

Neuroepidemiology

123

View full text Add to dashboard Cite

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“…It commonly presents as optic neuritis and acute longitudinally extensive transverse myelitis (LETM), either simultaneously or separately, with occasional involvement of other CNS areas (often as asymptomatic lesions). Prevalence has been estimated at 7-40/million, with higher rates in Asian and African populations [1,4,5]. Age at onset is typically 30-50 years, with female preponderance [6,7].…”

Section: Introductionmentioning

confidence: 99%

Combined Screening for Serum Anti-Nuclear and Anti-Aquaporin-4 Antibodies Improves Diagnostic Accuracy for Distinguishing Neuromyelitis Optica from Multiple Sclerosis

Huang

Yang

et al. 2014

Eur Neurol

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Background/Aims: Neuromyelitis optica spectrum disorders (NMOSDs) and multiple sclerosis (MS) are distinct clinical entities but are poorly distinguished by serum markers, including serum anti-aquaporin-4 (AQP4-Ab). We examined if testing for serum anti-nuclear antibodies (ANAs) and AQP4-Ab improved diagnostic sensitivity for NMOSDs. Methods: Chinese patients with NMOSDs (n = 74) or MS (n = 49) were screened for serum ANAs (all patients) and AQP4-Ab (58/74 NMOSDs and 45/49 MS patients). The NMOSDs group included patients with neuromyelitis optica (NMO; n = 53), recurrent longitudinally extensive transverse myelitis (rLETM; n = 20), and recurrent optic neuritis (n = 1). Results: The seroprevalence rate for ANAs was significantly higher in the NMOSDs group than the MS group (45.9 vs. 2%; p < 0.01). Similarly, AQP4-Ab seroprevalence was higher in NMOSDs than MS (56.9 vs. 4.4%; p < 0.01). Sensitivities and specificities for diagnosing NMOSDs were 51.7 and 97.8% using ANAs, 56.9 and 95.6% using AQP4-Ab, and 74.1 and 93.3% using both assays. Conclusion: Patients with NMO or rLETM had higher ANA seroprevalence than MS patients. Combined detection of both ANAs and AQP4-Ab improves the sensitivity of NMOSDs diagnosis without compromising specificity.

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“…Historically, it was believed that the prevalence of MS in Eastern Asia was 1-2 cases per 100 000 population. With multiple revisions of the diagnostic criteria, the improved availability of neurologists, and the increased use of MRI in the diagnosis of CNS (7) 11 (3) 13 (4) 11 ( population in northern Japan [29,30] . The prevalence of MS in Western Asia and the Middle East (including Kuwait, Israel, Turkey, Jordan, and Iraq) is believed to be higher than that in other parts of Asia, while Southern Asian countries such as India, Pakistan, Bangladesh, Sri Lanka, Nepal have a low rate of MS prevalence [31] .…”

Section: Distinct Features Of Multiple Sclerosis In Asian Countriesmentioning

confidence: 99%

Challenges in randomized controlled trials and emerging multiple sclerosis therapeutics

Huang¹

2015

Neurosci. Bull.

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The remarkable global development of disease-modifying therapies (DMTs) specific for multiple sclerosis (MS) has signifi cantly reduced the frequency of relapse, slowed the progression of disability, and improved the quality of life in patients with MS. With increasing numbers of approved DMTs, neurologists in North America and Europe are able to present multiple treatment options to their patients to achieve a better therapeutic outcome, and in many cases, no evidence of disease activity. MS patients have improved accessibility to various DMTs at no or minimal out-of-pocket cost. The ethical guidelines defi ned by the Edinburgh revision of the Declaration of Helsinki strongly discourage the use of placebo control groups in modern MS clinical trials. The use of an active comparator control group increases the number of participants in each group that is essential to achieve statistical signifi cance, thus further increasing the diffi culty of completing randomized controlled trials (RCTs) for the development of new MS therapies. There is evidence of a high prevalence of MS and a large number of patients in Asia. The belief of the existence of Asian types of MS that are distinct from Western types, and regulatory policies are among the reasons why DMTs are limited in most Asian countries. Lack of access to approved DMTs provides a good opportunity for clinical trials that are designed for the development of new MS therapies. Recently, data from RCTs have demonstrated excellent recruitment of participants and the completion of multi-nation and single-nation MS trials within this region. Recent studies using the McDonald MS diagnostic criteria carefully excluded patients with neuromyelitis optica (NMO) and NMO spectrum disorder, and demonstrated that patients with MS in Asia have clinical characteristics and treatment responses similar to those in Western countries.

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Increased prevalence, incidence, and female predominance of multiple sclerosis in northern Japan

Cited by 97 publications

References 32 publications

Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review

Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review

Combined Screening for Serum Anti-Nuclear and Anti-Aquaporin-4 Antibodies Improves Diagnostic Accuracy for Distinguishing Neuromyelitis Optica from Multiple Sclerosis

Challenges in randomized controlled trials and emerging multiple sclerosis therapeutics

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