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A significant decrease in diagnosis of primary progressive multiple sclerosis: A cohort study.

Helga Westerlind1, Leszek Stawiarz2, Katharina Fink3

  • 1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 14, 2016
PubMed
Summary
This summary is machine-generated.

The diagnosis of primary progressive multiple sclerosis (PPMS) has significantly decreased in Sweden, particularly after the introduction of disease-modifying treatments. This trend impacts future PPMS research and reflects current clinical practices.

Keywords:
Multiple sclerosischronic progressiveincidenceprevalence

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Area of Science:

  • Neurology
  • Epidemiology

Background:

  • Multiple sclerosis (MS) diagnosis, prevalence, and management have evolved.
  • Changes in diagnostic criteria and disease course definitions have occurred over decades.

Purpose of the Study:

  • To investigate temporal trends in primary progressive multiple sclerosis (PPMS) diagnoses within Sweden.
  • Analyze the changing proportion of PPMS diagnoses over time.

Main Methods:

  • Utilized data from the Swedish MS registry.
  • Analyzed PPMS diagnosis proportions across birth, diagnosis, and age cohorts using Poisson regression.

Main Results:

  • Observed a significant decrease in PPMS diagnoses from 19.2% to 2.2% in uncorrected analysis.
  • Adjusted analysis revealed an average decrease of 23% per 5-year birth cohort and 21% per diagnosis cohort.
  • Decreasing PPMS diagnosis trends were consistent across age-specific diagnosis periods.

Conclusions:

  • PPMS diagnosis rates have significantly declined in Sweden post-introduction of disease-modifying treatments.
  • This decline may impact future PPMS research and suggests current clinical emphasis on inflammatory activity.
  • Clinical practice appears to reflect the trend of emphasizing inflammatory activity in MS diagnosis.