Incidence and prevalence of multiple sclerosis in Europe: a systematic review

Abstract

BackgroundMultiple sclerosis (MS) is the most common cause of neurological disability in young adults worldwide and approximately half of those affected are in Europe. The assessment of differential incidence and prevalence across populations can reveal spatial, temporal and demographic patterns which are important for identifying genetic and environmental factors contributing to MS. However, study methodologies vary and the quality of the methods can influence the estimates. This study aimed to systematically review European studies of incidence and prevalence of MS and to provide a quantitative assessment of their methodological quality.MethodsA comprehensive literature search was performed to obtain all original population-based studies of MS incidence and prevalence in European populations conducted and published between January 1985 and January 2011. Only peer-reviewed full-text articles published in English or French were included. All abstracts were screened for eligibility and two trained reviewers abstracted the data and graded the quality of each study using a tool specifically designed for this study.ResultsThere were 123 studies that met the inclusion criteria. The study estimates were highly heterogeneous, even within regions or countries. Quality was generally higher in the more recent studies, which also tended to use current diagnostic criteria. Prevalence and incidence estimates tended to be higher in the more recent studies and were higher in the Nordic countries and in northern regions of the British Isles. With rare exceptions, prevalence and incidence estimates were higher in women with ratios as high as 3:1. Few studies examined ethnicity. Epidemiological data at the national level was uncommon and there were marked geographical disparities in available data, with large areas of Europe unrepresented and other regions well-represented in the literature. Only 37% of the studies provided standardized estimates.ConclusionsDespite the breadth of the literature on the epidemiology of MS in Europe, inter-study comparisons are hampered by the lack of standardization. Further research should focus on regions not yet studied and the evaluation of ethnic differences in MS prevalence and incidence. National-level studies using current diagnostic criteria, validated case definitions and similar age- and sex-standardization would allow better geographical comparisons.

Multiple sclerosis: patient-reported quality of life in the Świętokrzyskie Region

“…The onset of this disease usually begins between the ages of 20 and 40 years and is one of the main causes of disability among young people. Globally, the number of people with MS exceeds 2.5 million, of which approximately 600,000 live in Europe [2]. It is estimated that in Poland there are around 45,000 persons with MS, with around 2000 new cases diagnosed each year [3].…”

Living with Multiple Sclerosis in Europe: Pharmacological Treatments, Cost of Illness, and Health-Related Quality of Life Across Countries

“…Wilsdon et al (25) cite, among the international comparisons, Kingwell et al (26), who carried out a systematic review of incidence and prevalence of MS in Europe between 1985 and 2011. The authors concluded that prevalence and incidence estimates tended to be higher in the more recent studies, especially in the Nordic countries; they also stated that, despite the extent of the literature on the epidemiology of MS in Europe, inter-study comparisons are hindered by the lack of standardization.…”

Cost-Effectiveness Modeling in Multiple Sclerosis: Playing Around with Non-Healthcare Costs?

“…1 The seven studies finally selected [10][11][12][13][14][15][16] came from only four countries (Germany, Italy, Spain, and Sweden) ( Table 1); three focused on clinically isolated syndrome (CIS) 2 (comparing DMD vs. 'do nothing' or early vs. delayed regimens of the same DMD) and the other four on RRMS patients (comparing the two IFNbs and GA). Three studies included a cost-utility analysis, two a cost-effectiveness analysis, and the others both.…”

“…Accounting for more than half of the total population diagnosed with MS in the world, Europe is considered a high-prevalence region [1]. Patients with MS experience a wide range of signs and symptoms [2], which impair their capacity to perform day-to-day activities and thus quality of life [2,3].…”

“…Multiple sclerosis (MS) is a chronic disabling neurological disorder that affects more than two million people worldwide [1]. Accounting for more than half of the total population diagnosed with MS in the world, Europe is considered a high-prevalence region [1].…”