| Title: |
The risk of secondary progressive multiple sclerosis is geographically determined but modifiable |
| Authors: |
Sharmin, S; Roos, I; Simpson-Yap, S; Malpas, C; Sánchez, MM; Ozakbas, S; Horakova, D; Havrdova, EK; Patti, F; Alroughani, R; Izquierdo, G; Eichau, S; Boz, C; Zakaria, M; Onofrj, M; Lugaresi, A; Weinstock-Guttman, B; Prat, A; Girard, M; Duquette, P; Terzi, M; Amato, MP; Karabudak, R; Grand’Maison, F; Khoury, SJ; Grammond, P; Lechner-Scott, J; Buzzard, K; Skibina, O; van der Walt, A; Butzkueven, H; Turkoglu, R; Altintas, A; Maimone, D; Kermode, A; Shalaby, N; Pesch, VV; Butler, E; Sidhom, Y; Gouider, R; Mrabet, S; Gerlach, O; Soysal, A; Barnett, M; Kuhle, J; Hughes, S; Sa, MJ; Hodgkinson, S; Oreja-Guevara, C; Ampapa, R; Petersen, T; Ramo-Tello, C; Spitaleri, D; McCombe, P; Taylor, B; Prevost, J; Foschi, M; Slee, M; McGuigan, C; Laureys, G; Hijfte, LV; de Gans, K; Solaro, C; Oh, J; Macdonell, R; Aguera-Morales, E; Singhal, B; Gray, O; Garber, J; Wijmeersch, BV; Simu, M; Castillo-Triviño, T; Sanchez-Menoyo, JL; Khurana, D; Al-Asmi, A; Al-Harbi, T; Deri, N; Fragoso, Y; Lalive, PH; Sinnige, LGF; Shaw, C; Shuey, N; Csepany, T; Sempere, AP; Moore, F; Decoo, D; Willekens, B; Gobbi, C; Massey, J; Hardy, T; Parratt, J; Kalincik, T |
| Source: |
38th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis |
| Publisher Information: |
OXFORD UNIV PRESS |
| Publication Year: |
2023 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
Geographical variations in the incidence and prevalence of multiple sclerosis have been reported globally. Latitude as a surrogate for exposure to ultraviolet radiation but also other lifestyle and environmental factors are regarded as drivers of this variation. No previous studies evaluated geographical variation in the risk of secondary progressive multiple sclerosis, an advanced form of multiple sclerosis that is characterized by steady accrual of irreversible disability. We evaluated differences in the risk of secondary progressive multiple sclerosis in relation to latitude and country of residence, modified by high-to-moderate efficacy immunotherapy in a geographically diverse cohort of patients with relapsing-remitting multiple sclerosis. The study included relapsing-remitting multiple sclerosis patients from the global MSBase registry with at least one recorded assessment of disability. Secondary progressive multiple sclerosis was identified as per clinician diagnosis. Sensitivity analyses used the operationalized definition of secondary progressive multiple sclerosis and the Swedish decision tree algorithm. A proportional hazards model was used to estimate the cumulative risk of secondary progressive multiple sclerosis by country of residence (latitude), adjusted for sex, age at disease onset, time from onset to relapsing-remitting phase, disability (Multiple Sclerosis Severity Score) and relapse activity at study inclusion, national multiple sclerosis prevalence, government health expenditure, and proportion of time treated with high-to-moderate efficacy disease-modifying therapy. Geographical variation in time from relapsing-remitting phase to secondary progressive phase of multiple sclerosis was modelled through a proportional hazards model with spatially correlated frailties. We included 51 126 patients (72% female) from 27 countries. The median survival time from relapsing-remitting phase to secondary progressive multiple sclerosis among all patients was 39 (95% confidence interval: 37 to 43) years. ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0006-8950 |
| Relation: |
NHMRC/1129189; NHMRC/1140766; pii: 7208967; https://hdl.handle.net/11343/338890 |
| Availability: |
https://hdl.handle.net/11343/338890 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0 ; CC BY-NC |
| Accession Number: |
edsbas.F8F96C22 |
| Database: |
BASE |