Clinical and epidemiological characteristics of multiple sclerosis in students in the Republic of Bashkortostan

An expansion of the age range of multiple sclerosis (MS) manifestation has been reported recently. Considering the multifactorial etiology, high heterogeneity of the clinical symptoms, and the difficulties of early MS diagnosis in young people, the onset and course of this disease in students can be considered as one of the significant medical and social problems.Objective: to analyze the clinical and epidemiological characteristics of MS in university and secondary specialized educational institutions students in the Republic of Bashkortostan (RB).Patients and methods. This case-control study included 32 patients aged 15 to 24 years studying in universities and secondary schools of the RB. The clinical and epidemiological indicators analysis was carried out based on data from the register of MS patients in the RB. 32 sex-, age-, place of birth and residence-matching patients with MS, who were not students, were included in the control group.Results and discussion. The median age of disease manifestation in students was 18 [16.5; 20] years, in the control group – 16 [14; 19] years (p=0.010). We found a lower «disease onset – diagnosis» in the students group of revealed a lower interval «disease onset – diagnosis» (0.5 [0; 1] years, p=0.006), and a shorter duration of MS compared to the control group ((2.8 [2; 4] years and 4 [2; 7] years, respectively, p=0.020). Students with MS predominantly had movement disorders: central paresis and cerebellar ataxia. Students also had a faster MS progression (0.4 [0.2; 0.6] EDSS scores per year, p=0.001), despite of the disease-modifying therapies.Conclusion. MS manifestation and course in students receiving disease-modifying therapies indicate the need for close follow-up, adherence control, and psychological support in the educational process.

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Prevalence of Late-Onset Multiple Sclerosis in Fars Province, Southern Iran

Galen Medical Journal ◽

10.31661/gmj.v3i4.145 ◽

2014 ◽

Vol 3 (4) ◽

pp. 228-31

Author(s):

Sadegh Izadi ◽

Maryam Sharifian ◽

Alireza Nikseresht ◽

Shima Rafiee

Keyword(s):

Multiple Sclerosis ◽

Clinical Symptoms ◽

Late Onset ◽

Clinical History ◽

Fars Province ◽

Beta Interferon ◽

Disease Modifying Therapies ◽

Disease Modifying ◽

Disease Modifying Treatment ◽

Epidemiological Characteristics

Background: Multiple Sclerosis (MS) is the most common demyelinating and inflammatory disease of the central nevus system especially in young adults, but in a subgroup of patients the first clinical symptoms present after the age of 50. This clinical presentation is defined as Late-Onset Multiple Sclerosis (LOMS). The incidence and prevalence of MS including LOMS vary geographically. The aim of this study is to determine epidemiological characteristics of LOMS in Fars province, South of Iran.Materials and Methods: All patients aged over 50, known to have had definite MS according to MC Donald’s criteria, being members of Shiraz University Multiple Sclerosis Database (SUMSD), were evaluated in this study. The following data were recorded via a questionnaire indicating gender, age at the time of diagnosis, clinical course and details of disease- modifying therapies (Beta-Interferon).Results: Among a total of 1705 patients, 7.2% were identified as having LOMS and 3.1% identified as having very late-onset MS (VLOMS). Mean age of the patients with LOMS at the time of diagnosis was 58.81 ± 2.6 years (20.8% were male and 107 (79.2%) were female). 8.9 % had EDSS 6 and more. 89.1% of patients received Beta-Interferon as a disease-modifying treatment including Avonex (16.3 %), Cinovex (32.6%), Rebif (14.1%) and Betaferon (26.1 %). Conclusion: In our study, 7.2% of all MS patients were identified as LOMS. In LOMS subgroup, clinical history and para-clinical data should be thoroughly evaluated to exclude more common conditions like cerebrovascular disease. [GMJ. 2014;3(4):228-31]

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Analytical epidemiology of multiple sclerosis in the Republic of Kabardino-Balkaria

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2021-1s-10-14 ◽

2021 ◽

Vol 13 (1S) ◽

pp. 10-14

Author(s):

L. B. Tlapshokova ◽

A. R. Zikhova

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Environmental Factors ◽

Scarlet Fever ◽

Disease Onset ◽

Clinical Manifestations ◽

Control Group ◽

Place Of Residence ◽

History Of ◽

The Republic

Multiple sclerosis (MS) is a common autoimmune disease, which etiology includes a complex of genetic and environmental factors. Data suggests that their interaction can influence the age of the clinical manifestations and the course of the disease. Therefore, the study of risk factors of MS in regions with different ethnic compositions of the population and climatic and geographical characteristics is of considerable interest.Objective: to study MS risk factors prevalence in the Republic of Kabardino-Balkaria (RKB).Patients and methods. This case-control study of the representation of risk factors included a cohort of 112 MS patients living in two regions of the RKB (Nalchik and the Prokhladnensky district). The MS diagnosis was established with the McDonald criteria (2017). MS risk factors were assessed with a unified questionnaire. 112 respondents (matched by the main demographic characteristics and place of residence) were included in the control group.Results and discussion. MS patients from the Prokhladnensky district were significantly more likely to contact harmful chemical compounds, had higher consumption of smoked meat products; and suffered from viral infections more often (all differences were significant, p<0.05). More patients with MS, regardless of their place of residence, had a history of scarlet fever than the controls (n=23; 19.5% and n=14; 13.4%, ratio indicator 0.43 (95% CI 0.32–1.01), p=0.041), and the maximum significance of this factor was found in patients who suffered from scarlet fever after the age of 15 years (n=7; 6.3% and n=1; 0.9%, ratio indicator 2.45 (95% CI 1.92–3.21), p=0.041). More patients with MS had a history of chickenpox (n=70; 62.5% and n=55; 41.1%; ratio indicator 0.78 (95% CI 0.65–0.94, p=0.032), the frequency of this factor was most significant in early (up to 7 years) disease onset. Regardless of the place of residence, patients with MS were more likely to suffer from tonsillitis and sinusitis in childhood (p=0.032).Conclusion. In the RKB, as in other regions of the Russian Federation, the risk of MS, along with a genetic predisposition, is primarily determined by environmental factors, such as contact with potentially harmful chemicals, history of somatic diseases, characteristics of the ecological situation, etc. Therefore, MS risk is higher in people exposed to these factors before the age of 7 years and does not depend on the place of residence.

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Multiple sclerosis in the Republic of Tatarstan: epidemiological and clinical characteristics

Practical medicine ◽

10.32000/2072-1757-2020-5-50-57 ◽

2020 ◽

Vol 18 (5) ◽

pp. 50-57

Author(s):

F. A. KHABIROV ◽

◽

T. I. KHAYBULLIN ◽

E. V. GRANATOV ◽

L. A. AVERIANOVA ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Characteristics ◽

Disease Duration ◽

Dominant Type ◽

Adequate Treatment ◽

Primary Progressive ◽

Positive Tendency ◽

Disease Modifying Therapies ◽

The Republic ◽

Epidemiological Characteristics

The purpose — to clarify the clinical and epidemiological characteristics of multiple sclerosis (MS) in the Republic of Tatarstan (RT). Material and methods. A retrospective analysis of the register of MS patients in RT from 2015 to 2019 was carried out. The sample size was 2351 patients. The type of MS course, disease duration, clinical characteristics, including EDSS and MSSS scores, used by disease modifying therapies (DMT) were analyzed. Results and conclusions. The prevalence of MS in RT continues to grow and has increased by 29% over a 5-year period (from 46,6 to 60,3 per 100,000 population in 2015 and 2019, respectively). The incidence has relatively stabilized and averages 4,2 cases per 100,000 population per year. The dominant type of MS course in RT is remitting (51,3%), patients with progressive forms account for 48,7%, including those with primary progressive MS (6,9%). In RT, a positive tendency towards a more favorable course of the disease with a decrease in the degree of patients’ disability was traced, mainly due to early diagnosis and timely prescription of adequate treatment with DMT. The problem of timely diagnosis of MS in children and adolescents and in the primary progressive course of MS remains.

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Patient education programme on immunotherapy in multiple sclerosis (PEPIMS): a controlled rater-blinded study

Clinical Rehabilitation ◽

10.1177/0269215516639734 ◽

2016 ◽

Vol 31 (2) ◽

pp. 250-261 ◽

Cited By ~ 8

Author(s):

S Köpke ◽

J Kasper ◽

P Flachenecker ◽

H Meißner ◽

A Brandt ◽

...

Keyword(s):

Multiple Sclerosis ◽

Intervention Group ◽

Informed Choice ◽

Education Programme ◽

Control Group ◽

Evidence Based ◽

Disease Modifying Therapy ◽

Disease Modifying Therapies ◽

Disease Modifying ◽

Risk Knowledge

Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was “informed choice”, comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue. Results: A total of 156 patients were included (IG=75, CG=81). The intervention led to significantly more participants with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with adequate risk knowledge was significantly higher in the IG two weeks after the intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48% vs. CG: 31%, P=0.058). No significant differences were shown for positive attitude towards disease modifying therapy (IG: 62% vs. CG: 71%, P=0.29) and for disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%, P=0.39). Also no differences were found for autonomy preferences and decisional conflict after six months. Conclusion: Delivering evidence-based information on multiple sclerosis disease modifying therapies within a rehabilitation setting led to a marked increase of informed choices.

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Glatiramer acetate during early pregnancy: A prospective cohort study

Multiple Sclerosis Journal ◽

10.1177/1352458515623366 ◽

2016 ◽

Vol 22 (6) ◽

pp. 810-816 ◽

Cited By ~ 46

Author(s):

Sandra Herbstritt ◽

Annette Langer-Gould ◽

Milena Rockhoff ◽

Aiden Haghikia ◽

Annette Queisser-Wahrendorf ◽

...

Keyword(s):

Multiple Sclerosis ◽

Glatiramer Acetate ◽

First Trimester ◽

Control Group ◽

Disease Modifying Therapies ◽

Pregnancy And Postpartum ◽

Exposure During Pregnancy ◽

Disease Modifying ◽

Adverse Pregnancy ◽

Concomitant Medications

Background: Only limited data are available on whether glatiramer acetate exposure during pregnancy has an effect on perinatal outcome. Objective: To determine the effect of glatiramer acetate exposure during pregnancy on pregnancy outcomes in women with multiple sclerosis. Methods: We compared the outcome of pregnancies of women with multiple sclerosis exposed to glatiramer acetate with pregnancies unexposed to disease-modifying therapies. Women were enrolled into the German Multiple Sclerosis and Pregnancy registry. A standardized questionnaire was administered during pregnancy and postpartum. Detailed information on course of multiple sclerosis and pregnancy, concomitant medications, labor, delivery, and outcome of pregnancy was obtained. Results: We collected data on 246 multiple sclerosis pregnancies, 151 exposed to glatiramer acetate and 95 unexposed to disease-modifying therapies during pregnancy. Three (2.2%) congenital anomalies occurred in the exposed and 6 (6.7%) in the control group. We did not observe an increase in other adverse pregnancy or delivery outcomes including spontaneous abortions, preterm birth, Cesarean sections, or reduced birth weight in the exposed group. Conclusion: Our data provide further evidence that glatiramer acetate exposure during the first trimester of pregnancy appears safe and without teratogenic effect. These findings provide important additive knowledge to better counsel women with multiple sclerosis in planning a pregnancy.

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The course of multiple sclerosis rewritten: a Norwegian population-based study on disease demographics and progression

Journal of Neurology ◽

10.1007/s00415-020-10279-7 ◽

2020 ◽

Author(s):

Cecilia Smith Simonsen ◽

Heidi Øyen Flemmen ◽

Line Broch ◽

Cathrine Brunborg ◽

Pål Berg-Hansen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Disease Progression ◽

Disease Onset ◽

Population Based ◽

Natural Course ◽

Mixed Effect ◽

Patient Demographics ◽

Disease Modifying Therapies ◽

Norwegian Population ◽

Disease Modifying

Abstract Objectives Over the past few decades, there has been an improvement in the rate of disability progression in multiple sclerosis (MS) patients, and most studies relate this evolvement to the introduction of disease-modifying therapies. However, several other factors have changed over this period, including access to MRI and newer diagnostic criteria. The aim of this study is to investigate changes in the natural course of MS over time in a near-complete and geographically well-defined population from the south-east of Norway. Methods We examined disease progression and demographics over two decades and assessed the effect of disease-modifying therapies using linear mixed-effect models. Results In a cohort of 2097 patients, we found a significant improvement in disability as measured by the Expanded Disability Status Scale (EDSS) stratified by age, and the improvement remained significant after adjusting for time on disease-modifying medications, gender and progressive MS at onset. The time from disease onset to EDSS 6 in the total cohort was 29.8 years (95% CI 28.5–31.1) and was significantly longer in patients diagnosed after 2006 compared to patients diagnosed before. There are significant differences between patient demographics, as well as time to EDSS 6, in the near-complete, geographically well-defined population compared to an additional cohort from the capital Oslo and its suburbs. Conclusion The natural course of MS is improving, but the improvement seen in disease progression has multifaceted explanations. Our study underlines the importance of completeness of data, relevant timeframes and demographics when comparing different MS populations. Studies on incomplete populations should be interpreted with caution.

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