Selected aspects of epidemiology of multiple sclerosis in Poland: a multicenter pilot study

Multiple sclerosis (MS) is a progressive disease that, if untreated, leads to significant disability. In recent years, several effective disease-modifying therapies (DMTs) have been approved in the European Union and are now available in Poland. This study aimed to evaluate the selected epidemiological and clinical aspects of Polish individuals with MS and to compare the findings with data collected 15 years ago.

Sociodemographic and clinical data were collected from patients with MS between February and April 2024 using a standardized questionnaire across 19 treatment centers in Poland.

The study included 3,165 MS patients (mean age, 42.03 years; female-to-male ratio, 2.2:1). The mean disease duration was 10.6 ± 7.85 years, with symptom onset at 30.66 ± 9.84 years and diagnosis at 32.74 ± 10.22 years. The mean Expanded Disability Status Scale (EDSS) score was 2.58 ± 1.6, with mild disability (EDSS 0-3.5) in 78.35% of patients and moderate-to-severe disability (EDSS ≥ 4.0) in 21.65%. Multiple sclerosis subtypes included relapsing-remitting (RRMS) (86.87%), secondary progressive (SPMS) (7.04%), and primary progressive (PRMS) (6.03%). Relapses occurred in 20.43% of patients within the last year, with an overall annual relapse rate of 1.2 in this group. Monofocal onset of the disease was observed in 87.05% of patients, and multifocal onset in 12.95%. Comorbidities were present in 59.73% of patients. Diagnostic tests included magnetic resonance imaging (MRI) (99.84% of patients), cerebrospinal fluid (CSF) analysis (90.91% of patients), visual evoked potentials (VEP) (32.41% of patients), and optical coherence tomography (OCT) (16.11% of patients). At the time of data collection, 97.09% of patients were receiving DMTs, with the following distribution: dimethyl fumarate (25.91%), ofatumumab (16.44%), ocrelizumab (8.62%), teriflunomide (7.44%), natalizumab (5.80%), interferon beta-1a (5.58%), interferon beta-1b (4.97%), ozanimod (4.69%), siponimod (4.15%), glatiramer acetate (4.05%), fingolimod (3.29%), cladribine (3.20%), ponesimod (1.96%), and other therapies (0.88%).

This study highlights substantial progress in the diagnostic and therapeutic management of MS in Poland over the past 15 years. The widespread implementation of MRI and CSF analysis, alongside significantly improved access to DMTs, has contributed to notably better clinical outcomes. These improvements are reflected in reduced relapse rates, slower disability progression, and a decreased prevalence of secondary progressive MS.