Male sex is independently associated with faster disability accumulation in relapse-onset MS but not in primary progressive MS

Karen Ann Ribbons, Patrick McElduff, Cavit Boz, Maria Trojano, Guillermo Izquierdo, Pierre Duquette, Marc Girard, Francois Grand'Maison, Raymond Hupperts, Pierre Grammond, Celia Oreja-Guevara, Thor Petersen, Roberto Bergamaschi, Giorgio Giuliani, Michael Barnett, Vincent Van Pesch, Maria Pia Amato, Gerardo Iuliano, Marcela Fiol, Mark SleeFreek Verheul, Edgardo Cristiano, Ricardo Fernandez-Bolanos, Maria Laura Saladino, Maria Edite Rio, Jose Cabrera-Gomez, Helmut Butzkueven, Erik Van Munster, Leontien Den Braber-Moerland, Daniele La Spitaleri, Alessandra Lugaresi, Vahid Shaygannejad, Orla Gray, Norma Deri, Raed Alroughani, Jeannette Lechner-Scott

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112 Citations (Scopus)


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.

Original languageEnglish
Article numbere0122686
Number of pages11
JournalPLoS ONE
Issue number6
Publication statusPublished - 5 Jun 2015
Externally publishedYes

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