Incidence of multiple sclerosis among European Economic Area populations, 1985-2009: the framework for monitoring

Alcalde-Cabero, Enrique; Almazán-Isla, Javier; García‐Merino, Antonio; Sà, João de; Pedro‐Cuesta, Jesús de

doi:10.1186/1471-2377-13-58

Cited by 28 publications

(28 citation statements)

References 70 publications

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“…Overall, our results are in line with both the general pattern found in Europe , and geographical specificities described in France . The annual standardized incidence rate here calculated for Brittany (4.41/10 5 ) was close to those reported in European studies based on medical sources and using standardization on the European population to facilitate interstudy comparability.…”

Section: Discussionsupporting

confidence: 90%

Register‐based incidence of multiple sclerosis in Brittany (north‐western France), 2000–2001

Yaouanq

Tron²,

Kerbrat

et al. 2014

Acta Neurol Scand

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Objectives -To report on multiple sclerosis (MS) incidence in Brittany, north-western France. Materials & Methods -From 2000, we set up a population-based register for patients presenting a putative incident MS (PIMS), that is first symptoms compatible with MS onset. We used 3 medical sources of case ascertainment (neurologists, CSF, regional MS-Clinic). Eligibility criteria required both clinical onset and being permanent resident of Brittany in 2000 or 2001. From 2010, all medical records were tracked, the 10-year follow-up allowing previously reported data to be updated. This is an open access article under the terms of the Creative Commons Attribution-NonCommercialNoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionsupporting

confidence: 90%

Register‐based incidence of multiple sclerosis in Brittany (north‐western France), 2000–2001

Yaouanq

Tron²,

Kerbrat

et al. 2014

Acta Neurol Scand

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“…A recent meta‐analysis showed that a latitude gradient of MS incidence in Europe does indeed exist , and the same tendency was noted in another meta‐analysis . Two temporal trends were observed regarding the MS incidence: (i) a general increase in MS incidence and (ii) a decreased difference between geographic areas earlier attributed a high and low MS risk, such as northern vs southern Europe . Chile is a well‐suited country for studies on latitude gradients due to its elongated shape, and in one study, the incidence of hospitalizations because of MS was compared between regions .…”

Section: Sunshine and Ms Epidemiologymentioning

confidence: 71%

Vitamin D and multiple sclerosis-from epidemiology to prevention

Sundström

Salzer

2015

Acta Neurol Scand

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In the present review, we discuss observational and experimental data suggesting a protective effect from sun exposure and/or vitamin D in multiple sclerosis (MS). These data include geographic variations in MS occurrence, temporal trends, genetics, biobank, and questionnaire data. We look more closely at the differentiation between general effects from UV exposure, and those of vitamin D per se, including plausible mechanisms of action. Finally, primary prevention is touched upon, and we suggest actions to be taken while awaiting the results from ongoing randomized controlled trials with vitamin D in MS. The basis for the sunshine hypothesis in multiple sclerosis (MS) consists of epidemiological data on MS incidence and prevalence. These geographic variations in MS occurrence were commented upon already by Charcot and were early interpreted to show an increasing MS occurrence with increasing distance from the equator (1). Together with data from migration studies, an environmental factor in the etiology of MS was strongly suggested (reviewed in (2)). Sunshine and MS epidemiologyThe most natural factor related to the distance from the equator is sunshine-exposure to UV radiation. This notion has been considerably reinforced by studies showing that latitude is a poor proxy for UV radiation and that satellite-derived data on UV intensity, which provide a more accurate estimate of UV radiation, show a stronger association with MS occurrence (3-5).The latitude gradient in MS has been questioned recently (6), which has thrown some researchers into doubt about the sunshine hypothesis. The majority of MS epidemiological studies have studied prevalence. Prevalence data are less informative when etiological factors are considered, as the prevalence depends not only on the incidence in the last decades, but for chronic diseases like MS also on the mortality. Incidence studies are more difficult to perform and generally contain fewer cases but are superior for generating etiological hypotheses. It has been proposed that while MS prevalence data still show a latitude gradient, global MS incidence data, including Europe, do not, with the exception that the incidence gradient is still apparent in Australia and New Zealand (6).A recent meta-analysis showed that a latitude gradient of MS incidence in Europe does indeed exist (7), and the same tendency was noted in another meta-analysis (8). Two temporal trends were observed regarding the MS incidence: (i) a general increase in MS incidence (6, 7) and (ii) a decreased difference between geographic areas earlier attributed a high and low MS risk, such as northern vs southern Europe (7). Chile is a wellsuited country for studies on latitude gradients due to its elongated shape, and in one study, the incidence of hospitalizations because of MS was compared between regions (9). The authors reported no association between the incidence and latitude or UV radiation index. However, this was true after exclusion of the southernmost region, which 56

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“…Two-thirds of patients with MS are women, with a peak onset between 20 and 34 years of age, and approximately 10 % have disease onset during pregnancy [1–3]. CD peak onset is between 15 and 35 years of age, and in some regions there is a slight female predominance (20–30 % more frequently in women), particularly in high-incidence areas [4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of pregnancy outcomes from the Tysabri® (natalizumab) pregnancy exposure registry: a global, observational, follow-up study

et al. 2016

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BackgroundPatients with multiple sclerosis (MS) or Crohn’s disease (CD) being treated with natalizumab (Tysabri®, Biogen) who are planning to become pregnant or discover they are pregnant after exposure to natalizumab are currently advised to balance the potential benefits and potential risks of exposure when considering treatment options. This study was undertaken to evaluate pregnancy outcomes of women with MS or CD who were exposed to natalizumab at any time within 3 months prior to conception or during pregnancy. A pregnancy registry was created to better understand the effect of natalizumab exposure on pregnancy outcomes.MethodsThe Tysabri Pregnancy Exposure Registry was a global, observational exposure registration and follow-up study. Evaluations included spontaneous abortions (<22 weeks gestational age), fetal losses (≥22 weeks gestational age), ectopic pregnancies, elective or therapeutic terminations, stillbirths, birth defects, and live births. Birth defects were reviewed and coded in accordance with the Metropolitan Atlanta Congenital Defects Program (MACDP) classification of birth defects.ResultsA total of 369 patients with MS and 7 patients with CD were enrolled prospectively, of whom 355 patients (99.4 %; 349 MS and 6 CD) had known pregnancy outcomes (including 8 twin sets). The spontaneous abortion rate was 9.0 % (n = 32; 95 % confidence interval [C. I.], 6.3–12.5 %). An independent advisory committee review determined the major birth defect rate to be 5.05 % (16 of 316 live births + 1 elective abortion; 95 % C. I., 2.9–8.1 %). The mean gestational age of the live-born infants was 38.3 weeks, and the mean birth weight was 3158.3 g.ConclusionsAlthough the overall rate of birth defects was higher than that observed by the MACDP, these registry outcomes showed no specific pattern of malformations that would suggest a drug effect, and the spontaneous abortion rate was consistent with that of the general population.Trial registrationClinicalTrials.gov NCT00472992 (11 May 2007).

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Incidence of multiple sclerosis among European Economic Area populations, 1985-2009: the framework for monitoring

Cited by 28 publications

References 70 publications

Register‐based incidence of multiple sclerosis in Brittany (north‐western France), 2000–2001

Register‐based incidence of multiple sclerosis in Brittany (north‐western France), 2000–2001

Vitamin D and multiple sclerosis-from epidemiology to prevention

Evaluation of pregnancy outcomes from the Tysabri® (natalizumab) pregnancy exposure registry: a global, observational, follow-up study

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