Multiple Sclerosis Epidemiology in Europe

Battaglia, Mario Alberto

doi:10.1007/978-3-319-47861-6_9

Cited by 40 publications

(22 citation statements)

References 75 publications

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“…Studies from other European countries provide more up-to-date information but show a strong heterogeneity with the reported MS incidence ranging from 3.6 to 11.8 per 100,000 persons [11-22]. In general, the diverging results in studies may reflect regional differences of the MS incidence but could also be attributable to methodological inconsistencies with regard to MS case definitions [6, 23, 24] and the nature of the different data sources.…”

Section: Introductionmentioning

confidence: 92%

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Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

et al. 2017

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Background: Data on the incidence of multiple sclerosis (MS) on the national level is scarce. We aimed to estimate the incidence of MS in Germany and to compare different MS case definitions based on claims data. Methods: We conducted a cohort study with the German Pharmacoepidemiological Research Database in 2012 and calculated age- and gender-standardized incidence rates (sIRs) for 3 case definitions. In addition, the effect of stepwise reduction of the look-back period without MS diagnosis on the incidence rate was evaluated. Results: Our cohort comprised 4,175,877 individuals. The first case definition based on ICD-10 diagnoses yielded an sIR of 21.8 (95% CI 20.2–23.5) per 100,000 person years, whereas the second and third case definitions with additional requirements for drug treatment and diagnostic tests resulted in lower sIRs of 10.1 (9.1–11.3) and 6.6 (5.8–7.6) respectively. We observed a higher incidence for shorter look-back periods. Conclusion: The incidence of MS in Germany might be substantially higher than suggested in earlier studies. In addition, our study highlights the importance of a look-back period of at least 36 months to identify incident MS cases based on claims data.

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Section: Introductionmentioning

confidence: 92%

“…Large claims databases have recently been suggested as a valuable tool for studies on the epidemiology of MS, since analyses can be conducted rapidly and in a cost-efficient way [24]. In this study, we aimed to provide up-to-date estimates for the incidence of MS in Germany based on claims data using different MS case definitions.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

et al. 2017

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“…It is essential to have up-to-date estimates of MS prevalence to assess the impact of this chronic condition on the health care system and to allocate national and regional resources for the management of MS patients. MS has a heterogeneous prevalence in Europe [1, 2]. Only a few studies have investigated the prevalence of MS in France, providing estimates of national prevalence [3, 4], or local prevalence [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and mortality of patients with multiple sclerosis in France in 2012: a study based on French health insurance data

Foulon¹,

Maura²,

Dalichampt³

et al. 2017

J Neurol

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Data on the prevalence of multiple sclerosis (MS) in France are scarce. National and regional updated estimates are needed to better plan health policies. In this nationwide study, we provided estimates of the prevalence of MS in France in 2012 and mortality rate in 2013. MS cases were identified in the French national health insurance database (SNIIRAM-PMSI) using reimbursement data for disease-modifying treatment, long-term disease status for MS, disability pension for MS, and hospitalisation for MS (MS ICD-10 code: G35). We identified 99,123 MS cases, corresponding to an overall crude prevalence rate of 151.2 per 100,000 inhabitants [95% confidence interval (CI) 150.3–152.2]: 210.0 per 100,000 in women (95% CI 208.4–211.5) and 88.7 per 100,000 in men (95% CI 87.6–89.7). The overall prevalence rate was 155.6 per 100,000 inhabitants (95% CI 154.7–156.6) after standardization on the 2013-European population. We observed a prevalence gradient with a higher prevalence (190–200 per 100,000) in North-Eastern France and a lower prevalence in Southern and Western France (126–140). The crude mortality rate in 2013 was 13.7 per 1,000 MS cases (11.4 in women and 20.3 in men). The standardized mortality ratio was 2.56 (95% CI 2.41–2.72). Our results revise upwards the estimation of MS prevalence in France and confirm the excess mortality of MS patients compared to the general population.Electronic supplementary materialThe online version of this article (doi:10.1007/s00415-017-8513-0) contains supplementary material, which is available to authorized users.

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“…The epidemiological studies of the last decades indicate that the distribution of the disease in Mediterranean countries, in Italy in particular, is more complex than in the past, when a latitude-related model was proposed and commonly accepted [1][2][3][4][5]. The MS prevalence rates in southern Europe seem uneven, with variation between areas at the same latitude, and also within countries [6][7]. However, considering great differences in the methods and diagnostic criteria used in the studies, it is hard to compare recent studies with earlier ones and correctly explain the significance of the apparent temporal trend reported from the same areas [2][3].…”

Section: Introductionmentioning

confidence: 99%

Multiple Sclerosis in Italy: A 40-Year Follow-Up of the Prevalence in Ferrara

et al. 2018

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Background: To assess a longitudinal follow-up of the prevalence of multiple sclerosis (MS) through 4 decades in the province of Ferrara, northern Italy, and reappraise the current rates on December 31, 2016. Methods: We conducted a community-based intensive prevalence study, by adopting a complete enumeration approach. MS cases were identified from administrative health data and medical records from the Units of Neurology and Motor Rehabilitation, Ferrara University Hospital, from other provincial neurological structures and from archives of the National Pension Institute and National Health Insurance scheme of the study area. Case ascertainment method and case definition are analogous to those adopted in previous surveys in the same area of study. Results: On December 31, 2016, 685 patients (478 women and 207 men) affected by definite or probable MS (Poser’s criteria) were living in the province of Ferrara (population 386,896), yielding a crude prevalence ratio of 194.91 (95% CI 180.4–209.6) per 100,000, 260.8 (95% CI 238.10–285.82) for women and 123.1 (95% CI 106.98–141.21) for men The prevalence ratio was 26.9 per 100,000 in 1978, increased to a value of 46.1 per 100,000 in 1981, 69.4 per 100,000 in 1993, 120.9 per 100,000 in 2004. Female to male ratio was 2.31 (1.2 on December 31, 1978). The mean duration of the disease at prevalence day was 17.5 ± 11.9 years (13.9 ± 10.8 years in 1978). The mean age at prevalence day was 52.04 ± 10.8 years (13.8 ± 10.8 years in 1978). Conclusion: Our study has confirmed the province of Ferrara is an area at high risk for MS, in line with epidemiological data from the regions of continental and insular Italy. The sharp increase in MS prevalence over time in this population can be imputed in part to a greater exposition to risk factors in genetically susceptible subjects but also to an increased survival and improved ascertainment. So, the results suggest that both methodologic and environmental factors are essential in determining the real distribution of MS. The need to get reliable estimates of MS prevalence must be highlighted as a public health and research priority, essential to support planning and prioritization of care services and to reduce the overall burden of chronic disease.

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Multiple Sclerosis Epidemiology in Europe

Cited by 40 publications

References 75 publications

Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

Prevalence and mortality of patients with multiple sclerosis in France in 2012: a study based on French health insurance data

Multiple Sclerosis in Italy: A 40-Year Follow-Up of the Prevalence in Ferrara

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