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PLoS One. 2015 Jun 5;10(6):e0122686. doi: 10.1371/journal.pone.0122686. eCollection 2015.

Male Sex Is Independently Associated with Faster Disability Accumulation in Relapse-Onset MS but Not in Primary Progressive MS.

Author information

1
John Hunter Hospital, Newcastle, Australia.
2
University of Newcastle, Newcastle, Australia.
3
Karadeniz Technical University, Trabzon, Turkey.
4
University of Bari, Bari, Italy.
5
Hospital Universitario, Sevilla, Spain.
6
Hopital Notre Dame, Montreal, Canada.
7
Neuro Rive-Sud, Quebec, Canada.
8
Maaslandziekenhuis, Sittard, The Netherlands.
9
Hotel-Dieu de Levis, Quebec, Canada.
10
University Hospital La Paz, IdiPAZ, Madrid, Spain.
11
Kommunehospitalet, Arhus C, Denmark.
12
Neurological Institute IRCCS Mondino, Pavia, Italy.
13
Ospedale di Macerata, Macerata, Italy.
14
Brain and Mind Research Institute, Sydney, Australia.
15
Cliniques Universitaires Saint-Luc, Brussels, Belgium.
16
Department of Neurology, University of Florence, Florence, Italy.
17
Ospedali Riuniti di Salerno, Salerno, Italy.
18
FLENI, Buenos Aires, Argentina.
19
Flinders Medical Centre, Adelaide, Australia.
20
Groen Hart Ziekenhuis, Gouda, Netherlands.
21
Hospital Italiano, Buenos Aires, Argentina.
22
Hospital Universitario Virgen de Valme, Seville, Spain.
23
Craigavon Area Hospital, Craigavon, Northern Ireland.
24
Hospital S. João, Porto, Portugal.
25
Multiple Sclerosis Clinic, International Center of Neurological Restoration, Havana, Cuba.
26
Royal Melbourne Hospital, Melbourne, Australia.
27
Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands.
28
Francicus Ziekenhuis, Roosendaal, Netherlands.
29
AORN San Giuseppe Moscati, Avellino, Italy.
30
Dept Neuroscience and Imaging-Univ "G. d'Annunzio", Chieti, Italy.
31
Al-Zahara Hopsital, Isfahan University of Medical Sciences, Isfahan, Iran.
32
Craigavon Area Hospital, Armagh, Northern Ireland.
33
Hospital Fernandez, Capital Federal, Argentina.
34
Amiri Hospital, Qurtoba, Kuwait.

Abstract

BACKGROUND:

Multiple Sclerosis is more common in women than men and females have more relapses than men. In a large international cohort we have evaluated the effect of gender on disability accumulation and disease progression to determine if male MS patients have a worse clinical outcome than females.

METHODS:

Using the MSBase Registry, data from 15,826 MS patients from 25 countries was analysed. Changes in the severity of MS (EDSS) were compared between sexes using a repeated measures analysis in generalised linear mixed models. Kaplan-Meier analysis was used to test for sex difference in the time to reach EDSS milestones 3 and 6 and the secondary progressive MS.

RESULTS:

In relapse onset MS patients (n = 14,453), males progressed significantly faster in their EDSS than females (0.133 vs 0.112 per year, P<0.001,). Females had a reduced risk of secondary progressive MS (HR (95% CI) = 0.77 (0.67 to 0.90) P = 0.001). In primary progressive MS (n = 1,373), there was a significant increase in EDSS over time in males and females (P<0.001) but there was no significant sex effect on the annualized rate of EDSS change.

CONCLUSION:

Among registrants of MSBase, male relapse-onset patients accumulate disability faster than female patients. In contrast, the rate of disability accumulation between male and female patients with primary progressive MS is similar.

PMID:
26046348
PMCID:
PMC4457630
DOI:
10.1371/journal.pone.0122686
[Indexed for MEDLINE]
Free PMC Article

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