Relapsing and progressive MS: the sex-specific perspective

Abstract

Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease whose aetiology is not fully understood. The female sex is clearly predominant, with a sex ratio between 2 and 3. In primary progressive MS the sex ratio almost balances out. Since the age at onset is higher for patients with progressive onset (POMS) than for relapsing onset (ROMS), it can be hypothesized that the age at onset is a decisive factor for the sex ratio. Methods: To address this aspect, we compare clinical and demographic data between females and males for the different disease courses within the population of the German MS Register by the German MS Society. Only patients with complete details in mandatory data items and a follow-up visit since 01. Jan 2018 were included. Results: A total of 18,728 patients were included in our analyses, revealing a female-to-male ratio of 2.6 (2.7 for patients with ROMS and 1.3 for POMS). The age at diagnosis is higher in patients with POMS (43.3 and 42.3 years for females and males versus 32.1 and 33.2 years, respectively). Females irrespective of disease course are statistically significantly more often affected by cognitive impairment (POMS: p = 0.013, ROMS: p = 0.001) and depression (POMS: p = 0.002, ROMS: 0.001) and suffer more often from pain (POMS and ROMS: p < 0.001). Fatigue is significantly more often seen in females with ROMS ( p < 0.001) but not in POMS. Females with ROMS retire significantly ( p < 0.001) earlier (42.8 versus 44.2 years) and to a greater extent than males (28 versus 24%). Disease progression was similar for women and men. Conclusion: Our analysis shows that clinical and demographic data differ more between disease courses than between men and women. For pain, depression and cognitive impairment the female sex is the decisive factor. Whether these factors are responsible for the earlier retirement of females with ROMS is not clear. Appropriate measures for optimization of symptomatic treatment as well as to promote employment should be taken.

Chances and challenges of a long-term data repository in multiple sclerosis: 20th birthday of the German MS registry

“…As a result, the dataset is a combination of datasets of the German Multiple Sclerosis Society and the German Competence Network Multiple Sclerosis. The current minimal dataset (see Supplementary Table 1 ) contains information on disease onsets, diagnoses, MS disease courses 19 , 20 , disabilities (as measured in EDSS and MS Functional Composite as well by MS Symptoms), disease activity, MS therapy and socio-economic statuses 21 . In 2019, the GMSR dataset was extended by a pharmacovigilance module to include documentation on medical history, body mass index, adverse events and pregnancies (see Table 2 ).…”

Correlation of Lower Limb Muscle Strength with Functional Mobility and Quality of Life in Patients with Multiple Sclerosis

“…Lower limb muscle strength x Functional Mobility Discussion Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease whose etiology is still not fully understood. In MS the female gender is clearly predominant, with a sex ratio of 2 to 3 compared to males 24 . In our sample, the majority of participants were female (female-to-male ratio of 1.63:1) and classified with relapsing-remitting MS.…”

Genetic risk variants for multiple sclerosis are linked to differences in alternative pre-mRNA splicing

“…The etiology of MS is still unclear. However, environmental and lifestyle factors, such as smoking, adolescent obesity, and Epstein–Barr virus (EBV) infection, as well as genetic predisposition have been identified as risk factors contributing to the development of MS ( 25 – 29 ). Single-nucleotide polymorphisms (SNPs), the variations of single base pairs at specific genome locations, are the most common type of genetic risk factors ( 30 , 31 ).…”