Male Sex Is Independently Associated with Faster Disability Accumulation in Relapse-Onset MS but Not in Primary Progressive MS

PLoS One. 2015 Jun 5;10(6):e0122686. doi: 10.1371/journal.pone.0122686. eCollection 2015.

Abstract

Background: Multiple Sclerosis is more common in women than men and females have more relapses than men. In a large international cohort we have evaluated the effect of gender on disability accumulation and disease progression to determine if male MS patients have a worse clinical outcome than females.

Methods: Using the MSBase Registry, data from 15,826 MS patients from 25 countries was analysed. Changes in the severity of MS (EDSS) were compared between sexes using a repeated measures analysis in generalised linear mixed models. Kaplan-Meier analysis was used to test for sex difference in the time to reach EDSS milestones 3 and 6 and the secondary progressive MS.

Results: In relapse onset MS patients (n = 14,453), males progressed significantly faster in their EDSS than females (0.133 vs 0.112 per year, P<0.001,). Females had a reduced risk of secondary progressive MS (HR (95% CI) = 0.77 (0.67 to 0.90) P = 0.001). In primary progressive MS (n = 1,373), there was a significant increase in EDSS over time in males and females (P<0.001) but there was no significant sex effect on the annualized rate of EDSS change.

Conclusion: Among registrants of MSBase, male relapse-onset patients accumulate disability faster than female patients. In contrast, the rate of disability accumulation between male and female patients with primary progressive MS is similar.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Databases, Factual
  • Disability Evaluation
  • Disease Progression
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / mortality
  • Multiple Sclerosis / pathology*
  • Proportional Hazards Models
  • Recurrence
  • Registries
  • Severity of Illness Index
  • Sex Factors

Substances

  • Immunologic Factors

Grant support

Merck Serono supports iMED which is the software program used by MSBASE for data acquisition at each collaborating centre and does not impact on the studies derived from data collected by this program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.