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Prevalence of pediatric multiple sclerosis in Germany: A nationwide population-based analysis
Niklas Frahm1, Melanie Peters2, Jörg Bätzing3
1MS Research and Project Development, Hannover, Germany.
Insights
Pediatric multiple sclerosis (MS) prevalence remained stable in Germany from 2009-2018, with a notable increase in older adolescents and a female predominance in this age group. This trend highlights evolving patterns in pediatric MS epidemiology.
Area of Science:
- Neurology
- Epidemiology
- Pediatrics
Background:
- Accurate pediatric multiple sclerosis (MS) prevalence data are crucial for understanding global trends.
- Previous studies lacked comprehensive, long-term data on pediatric MS epidemiology in Germany.
Purpose of the Study:
- To analyze changes in the prevalence of multiple sclerosis (MS) diagnoses in pediatric patients in Germany over a 10-year period (2009-2018).
- To identify age- and sex-specific trends in pediatric MS prevalence.
Main Methods:
- Utilized nationwide outpatient claims data from German statutory health insurance, covering children under 18 years old (n=11,381,939 in 2018).
- Identified individuals with MS using the International Classification of Diseases, 10th Revision (ICD-10-GM code G35.x).
- Analyzed annual pediatric MS diagnosis prevalence by age, sex, and region from 2009 to 2018.
Main Results:
- Overall pediatric MS prevalence slightly increased from 5.3 to 5.4 per 100,000 children under 18.
- Prevalence increased in adolescents aged 15-17 years (19.6-22.7/100,000) but slightly decreased in those ≤14 years (1.9-1.7/100,000).
- The female-to-male ratio was 1.32 for children ≤14 years and 2.47 for adolescents 15-17 years in 2018.
- Regional prevalence differences between East and West Germany converged after 2012.
Conclusions:
- This study represents the largest analysis of pediatric MS prevalence globally, covering 87% of German children.
- Pediatric MS prevalence shows an increasing trend, particularly in older adolescents, with a notable female predominance in this group.
- Findings underscore the importance of continued epidemiological surveillance for pediatric MS.
Background And Purpose:
Prevalence data are needed to reveal trends regarding the pediatric multiple sclerosis (MS) situation worldwide. The aim was to identify changes in MS diagnosis prevalence in pediatric patients over a 10-year period in Germany.
Methods:
This analysis is based on nationwide outpatient claims data of children aged <18 years covered by the German statutory health insurance (n = 11,381,939 in 2018). People with MS (PwMS) had ≥1 documented MS diagnosis (International Classification of Diseases, 10th Revision, German modification code G35.x). The annual pediatric MS diagnosis prevalence was analyzed regarding age, sex, and place of residence during 2009-2018.
Results:
The prevalence of pediatric MS developed from 5.3 (2009) to 5.4 (2018)/100,000 insured population aged <18 years. The MS prevalence in patients aged 15-17 years showed a moderate increase over 10 years (19.6-22.7/100,000), whereas patients ≤14 years old showed a slight decrease (1.9-1.7/100,000). The sex ratio (female:male) in 2018 was relatively balanced in PwMS aged ≤14 years (1.32) but female-dominated in those aged 15-17 years (2.47). The formerly different prevalence of pediatric MS between East and West Germany has converged since 2012.
Conclusions:
So far, this is the largest study of pediatric MS prevalence in terms of source population size (87% of German children <18 years of age, n = 11,381,939 in 2018) and study period (2009-2018) worldwide. The analyses revealed an increase in MS prevalence and a female-dominated sex ratio in "older" adolescents compared to younger patients.
