Thränhardt, Pauline; Veselaj, Admirim; Friedli, Christoph; Wagner, Franca; Marti, Stefanie; Diem, Lara; Hammer, Helly; Radojewski, Piotr; Wiest, Roland; Chan, Andrew; Hoepner, Robert; Salmen, Anke (2024). Sex differences in multiple sclerosis relapse presentation and outcome: a retrospective, monocentric study of 134 relapse events. Therapeutic advances in neurological disorders, 17(17562864241237853) Sage 10.1177/17562864241237853
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BACKGROUND
Reporting of sex-specific analyses in multiple sclerosis (MS) is sparse. Disability accrual results from relapses (relapse-associated worsening) and independent thereof (progression independent of relapses).
OBJECTIVES
A population of MS patients during relapse treated per standard of care was analyzed for sex differences and short-term relapse outcome (3-6 months) as measured by Expanded Disability Status Scale (EDSS) change.
DESIGN
Single-center retrospective study.
METHODS
We analyzed 134 MS relapses between March 2016 and August 2020. All events required relapse treatment (steroids and/or plasma exchange). Demographic, disease, and paraclinical characteristics [cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI)] were displayed separated by sex. Multivariable linear regression was run to identify factors associated with short-term EDSS change.
RESULTS
Mean age at relapse was 38.4 years (95% confidence interval: 36.3-40.4) with a proportion of 71.6% women in our cohort. Smoking was more than twice as prevalent in men (65.8%) than women (32.3%). In- and after-relapse EDSSs were higher in men [men: 3.3 (2.8-3.9), women: 2.7 (2.4-3.0); men: 3.0 (1.3-3.6); women: 1.8 (1.5-2.1)] despite similar relapse intervention. Paraclinical parameters revealed no sex differences. Our primary model identified female sex, younger age, and higher EDSS at relapse to be associated with EDSS improvement. A higher immunoglobulin G (IgG) quotient (CSF/serum) was associated with poorer short-term outcome [mean days between first relapse treatment and last EDSS assessment 130.2 (79.3-181.0)].
CONCLUSION
Sex and gender differences are important in outcome analyses of MS relapses. Effective treatment regimens need to respect putative markers for a worse outcome to modify long-term prognosis such as clinical and demographic variables, complemented by intrathecal IgG synthesis. Prospective trials should be designed to address these differences and confirm our results.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology ?? DDA265BCC8594EC2A20587A7CA7251BD ?? 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology |
UniBE Contributor: |
Thränhardt, Pauline, Friedli, Christoph Daniel, Wagner, Franca, Marti, Stefanie Laura, Diem, Lara, Hammer, Helly Noemi, Radojewski, Piotr, Wiest, Roland Gerhard Rudi, Chan, Andrew Hao-Kuang, Hoepner, Robert, Salmen, Anke |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1756-2856 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
02 Apr 2024 14:30 |
Last Modified: |
03 Apr 2024 02:39 |
Publisher DOI: |
10.1177/17562864241237853 |
PubMed ID: |
38532803 |
Uncontrolled Keywords: |
EDSS MS gender plasma exchange steroid |
BORIS DOI: |
10.48350/194954 |
URI: |
https://boris.unibe.ch/id/eprint/194954 |
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