PLoS ONE (Jan 2015)

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

  • Karen Ann Ribbons,
  • Patrick McElduff,
  • Cavit Boz,
  • Maria Trojano,
  • Guillermo Izquierdo,
  • Pierre Duquette,
  • Marc Girard,
  • Francois Grand'Maison,
  • Raymond Hupperts,
  • Pierre Grammond,
  • Celia Oreja-Guevara,
  • Thor Petersen,
  • Roberto Bergamaschi,
  • Giorgio Giuliani,
  • Michael Barnett,
  • Vincent van Pesch,
  • Maria-Pia Amato,
  • Gerardo Iuliano,
  • Marcela Fiol,
  • Mark Slee,
  • Freek Verheul,
  • Edgardo Cristiano,
  • Ricardo Fernandez-Bolanos,
  • Maria-Laura Saladino,
  • Maria Edite Rio,
  • Jose Cabrera-Gomez,
  • Helmut Butzkueven,
  • Erik van Munster,
  • Leontien Den Braber-Moerland,
  • Daniele La Spitaleri,
  • Alessandra Lugaresi,
  • Vahid Shaygannejad,
  • Vahid Shaygannejad,
  • Orla Gray,
  • Norma Deri,
  • Raed Alroughani,
  • Jeannette Lechner-Scott

DOI
https://doi.org/10.1371/journal.pone.0122686
Journal volume & issue
Vol. 10, no. 6
p. e0122686

Abstract

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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.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.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.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.