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

Yaouanq, J.; Tron, Isabelle; Kerbrat, Anne; Leray, Emmanuelle; Hamonic, Stéphanie; Merienne, M; Hinault, P; Edan, Gilles

doi:10.1111/ane.12332

Cited by 14 publications

(10 citation statements)

References 24 publications

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“…The annual standardized incidence rate here estimated for Brittany (5.7 per 100,000 inhabitants) is close to those reported in French and other European studies based on medical sources [ 9 , 12 , 22 ], keeping in mind that inter-study comparisons are hampered by the marked variability in the methodology, time period and diagnostic criteria [ 22 ]. The only study of a similar design (to our best knowledge), reported an onset-adjusted incidence rate of 3.6 per 100,000 inhabitants in the Girona province in Catalonia (Spain) but did not consider PPMS [ 23 ].…”

Section: Discussionsupporting

confidence: 84%

“…To tackle this epidemiological challenge, MS has been identified using patient records at hospitals and at private neurological practices that provide on-going care to the Brittany population (including the University hospital in the neighboring Pays-de-Loire region, which could evaluate patients seeking medical attention outside their zone of residence). Data files were available from a previous epidemiological study conducted during 2000–2004, which assessed MS incidence during 2000–2001 [ 12 ]. We extended this serial follow-up to 2016 to correct the effects of diagnostic delays.…”

Section: Methodsmentioning

confidence: 99%

“…A further difficulty was that the diagnostic criteria of Poser were used by neurologists at the beginning of the study period but were progressively superseded by the McDonald system. Therefore, following Yaouanq et al [ 12 ], to ultimately be included in the study, incident cases had to fulfill the McDonald criteria for MS or at least the Poser criteria for probable or definite MS. All patient charts were reviewed and scrutinized by only one neurologist (JY) for data on gender, year of birth, course of disease at onset, year of disease onset, year of first clinical examination for symptoms suggestive of MS, and place of residence at time of clinical onset. In cases where the location at clinical onset or the location within the following year (120 of 848, 14%) was missing, the nearest place of residence available from medical records was used.…”

Section: Methodsmentioning

confidence: 99%

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Small-area distribution of multiple sclerosis incidence in western France: in search of environmental triggers

et al. 2017

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BackgroundDespite intensive research over several decades, the etiology of multiple sclerosis (MS) remains poorly understood, although environmental factors are supposedly implicated. Our goal was to identify spatial clusters of MS incident cases at the small-area level to provide clues to local environmental risk factors that might cause or trigger the disease.MethodsA population-based and multi-stage study was performed in the French Brittany region to accurately ascertain the clinical onset of disease during the 2000–2004 period. The municipality of residence at the time of clinical onset was geocoded. To test for the presence of MS incidence clusters and to identify their approximate locations, we used a spatial scan statistic. We adjusted for socioeconomic deprivation, known to be strongly associated with increased MS incident rates, and scanned simultaneously for areas with either high or low rates. Sensitivity analyses (focusing on relapsing-remitting forms and/or places of residence available within the year following clinical onset) were performed.ResultsA total of 848 incident cases of MS were registered in Brittany, corresponding to a crude annual incidence rate of 5.8 per 100,000 inhabitants. The spatial scan statistic did not find a significant cluster of MS incidence in either the primary analysis (p value ≥ 0.56) or in the sensitivity analyses (p value ≥ 0.16).ConclusionThe findings of this study indicate that MS incidence is not markedly affected across space, suggesting that in the years preceding the first clinical expression of the disease, no environmental trigger is operative at the small-area population level in the French Brittany region.

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Section: Discussionsupporting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Small-area distribution of multiple sclerosis incidence in western France: in search of environmental triggers

et al. 2017

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“…In the most recent study based on registry data from the urban district of Erfurt, an average annual incidence of 8 per 100,000 persons was found between 1998 and 2002 [10]. Studies from other European countries provide more up-to-date information but show a strong heterogeneity with the reported MS incidence ranging from 3.6 to 11.8 per 100,000 persons [11-22]. In general, the diverging results in studies may reflect regional differences of the MS incidence but could also be attributable to methodological inconsistencies with regard to MS case definitions [6, 23, 24] and the nature of the different data sources.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

et al. 2017

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Background: Data on the incidence of multiple sclerosis (MS) on the national level is scarce. We aimed to estimate the incidence of MS in Germany and to compare different MS case definitions based on claims data. Methods: We conducted a cohort study with the German Pharmacoepidemiological Research Database in 2012 and calculated age- and gender-standardized incidence rates (sIRs) for 3 case definitions. In addition, the effect of stepwise reduction of the look-back period without MS diagnosis on the incidence rate was evaluated. Results: Our cohort comprised 4,175,877 individuals. The first case definition based on ICD-10 diagnoses yielded an sIR of 21.8 (95% CI 20.2–23.5) per 100,000 person years, whereas the second and third case definitions with additional requirements for drug treatment and diagnostic tests resulted in lower sIRs of 10.1 (9.1–11.3) and 6.6 (5.8–7.6) respectively. We observed a higher incidence for shorter look-back periods. Conclusion: The incidence of MS in Germany might be substantially higher than suggested in earlier studies. In addition, our study highlights the importance of a look-back period of at least 36 months to identify incident MS cases based on claims data.

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“…The first type of studies estimated multiple sclerosis prevalence to be (a) between 128 and 171/100,000 in Brittany 22 (vs 132/100,000 in our study), (b) 188.2/100,000 in Lorraine 23 (vs 153/100,000 in our study), and (c) between 110 and 149/100,000 in Haute Garonne 24 (vs 109/100,000 in our study). The second type of study estimated multiple sclerosis prevalence to be (a) 65/100,000 in France in agricultural workers 5 (vs 100.39/100,000 in our study) and (b) 94/100,000 in France in employees 6 (vs 100.39/100,000 in our study).…”

Section: Discussionmentioning

confidence: 99%

Geographic variations of multiple sclerosis prevalence in France: The latitude gradient is not uniform depending on the socioeconomic status of the studied population

Ha-Vinh¹,

Nauleau

Clementz³

et al. 2016

Multiple Sclerosis Journal - Experimental, Translational and Cl

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BackgroundIn France, two studies analysed multiple sclerosis prevalence nationwide: one was carried out in farmers, and the other one in employees. A south-north gradient of prevalence was found solely in farmers.ObjectiveIn order to better describe the latitude gradient in France, which is not uniform depending on the studied population, we assessed whether a gradient exists in another population than farmers and employees: independent workers. The same methods of case ascertainment have been used.MethodsAltogether 4,165,903 persons insured by the French health insurance scheme for independent workers were included. We searched the database for (a) long term disease status ‘multiple sclerosis’, (b) domicile, (c) gender and (d) age.ResultsA total of 4182 cases of multiple sclerosis were registered giving a prevalence of 100.39/100,000. Adjustment by age and sex and spatial smoothing with a Bayesian analysis showed a gradual increase of prevalence from the southwest to the northeast of France. Standardised morbidity ratio was correlated with latitude and longitude (p<0.0001; p = 0.0031; adjusted R2 = 0.3038).ConclusionA discrepancy of geographic distribution between farmers and independent workers on the one hand and employees on the other cannot be attributable to environment. Assuming that socioeconomic status by itself is not associated with multiple sclerosis risk, employees’ geographic mobility at adulthood for professional reasons could have interfered with the gradient effect.

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

Cited by 14 publications

References 24 publications

Small-area distribution of multiple sclerosis incidence in western France: in search of environmental triggers

Small-area distribution of multiple sclerosis incidence in western France: in search of environmental triggers

Incidence of Multiple Sclerosis in Germany: A Cohort Study Applying Different Case Definitions Based on Claims Data

Geographic variations of multiple sclerosis prevalence in France: The latitude gradient is not uniform depending on the socioeconomic status of the studied population

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