Contributions
Abstract: EP1324
Type: ePoster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: We previously reported that the prevalence and incidence of multiple sclerosis (MS) in Tokachi province, northern Japan, have increased in the last15 years; accordingly, there have been changes in the clinical characteristics of patients with MS.
Objectives: To clarify the prognostic factors of MS in the Japanese population in Tokachi province using data obtained from 4 epidemiologic studies in the last 15 years.
Methods: Beginning in 2001, we have conducted prevalence studies every five years in the Tokachi province of Japan containing relevant clinical data for all included patients. Poser's criteria were used for diagnosis of MS in the four studies. The Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) were used to evaluate disease severity and disability progression, respectively. In our 2016 survey, MS patients were divided into two groups: the mild progression group (MSSS < 3) and the non-mild progression group (MSSS >3).
Results: The MS prevalence and female/male ratio in Tokachi province increased from 8.1/100,000 (95% confidence intervals [CI] 5.4-11.7) and 2.6 in 2001 to 18.6/100,000 (95% CI 14.3-23.8) and 3.6 in 2016, respectively. Conversely, mean/median EDSS decreased from 3.0/2.3 in 2001 to 2.3/1.0 in 2016, respectively. Our 2016 surveillance data revealed that the mild progression group received fewer treatments with disease-modifying drugs (DMDs) than the non-mild group (50% vs 85%, p< 0.05), although there was no significant difference in disease duration between groups. Based on the multivariate analysis of factors influencing the non-mild progression group, male gender (OR 19.0; 95% CI 2.8-128), older age (OR 1.18; 95% CI 1.06-1.31), and positivity for oligoclonal bands (OCBs) (OR 19.1; 95% CI 1.6-233) were associated with a higher risk of progression. Age at onset was not correlated with disease progression.
Conclusions and relevance: Lower rates of treatment with DMDs in the mild progression group suggest that some patients do not necessarily need DMDs for good MS prognosis. Our data obtained from all MS patients in this cohort demonstrate that gender, birth year, and OCBs may be candidate prognostic factors for MS in the population in northern Japan. The increasing prevalence of MS in younger female patients may result in an increased proportion of patients with mild MS regardless of the use of DMDs treatments in northern Japan.
Disclosure:
H. Houzen has received funding for travel and/or speaker honoraria from Biogen, Mitsubishi Tanabe Pharma Corporation, and Takeda Pharmaceutical Company.
H.Sato and K. Kondo reports no disclosures.
M. Niino has received funding for travel and/or speaker honoraria from Biogen, Mitsubishi Tanabe Pharma Corporation, and Takeda Pharmaceutical Company; is part of a scientific advisory board for Biogen and Chugai Pharmaceutical Company; and has received research support from Grants-in-Aid for Scientific Research from the Ministry of Health, Labor and Welfare of Japan.
Abstract: EP1324
Type: ePoster
Abstract Category: Clinical aspects of MS - 4 Natural course
Background: We previously reported that the prevalence and incidence of multiple sclerosis (MS) in Tokachi province, northern Japan, have increased in the last15 years; accordingly, there have been changes in the clinical characteristics of patients with MS.
Objectives: To clarify the prognostic factors of MS in the Japanese population in Tokachi province using data obtained from 4 epidemiologic studies in the last 15 years.
Methods: Beginning in 2001, we have conducted prevalence studies every five years in the Tokachi province of Japan containing relevant clinical data for all included patients. Poser's criteria were used for diagnosis of MS in the four studies. The Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) were used to evaluate disease severity and disability progression, respectively. In our 2016 survey, MS patients were divided into two groups: the mild progression group (MSSS < 3) and the non-mild progression group (MSSS >3).
Results: The MS prevalence and female/male ratio in Tokachi province increased from 8.1/100,000 (95% confidence intervals [CI] 5.4-11.7) and 2.6 in 2001 to 18.6/100,000 (95% CI 14.3-23.8) and 3.6 in 2016, respectively. Conversely, mean/median EDSS decreased from 3.0/2.3 in 2001 to 2.3/1.0 in 2016, respectively. Our 2016 surveillance data revealed that the mild progression group received fewer treatments with disease-modifying drugs (DMDs) than the non-mild group (50% vs 85%, p< 0.05), although there was no significant difference in disease duration between groups. Based on the multivariate analysis of factors influencing the non-mild progression group, male gender (OR 19.0; 95% CI 2.8-128), older age (OR 1.18; 95% CI 1.06-1.31), and positivity for oligoclonal bands (OCBs) (OR 19.1; 95% CI 1.6-233) were associated with a higher risk of progression. Age at onset was not correlated with disease progression.
Conclusions and relevance: Lower rates of treatment with DMDs in the mild progression group suggest that some patients do not necessarily need DMDs for good MS prognosis. Our data obtained from all MS patients in this cohort demonstrate that gender, birth year, and OCBs may be candidate prognostic factors for MS in the population in northern Japan. The increasing prevalence of MS in younger female patients may result in an increased proportion of patients with mild MS regardless of the use of DMDs treatments in northern Japan.
Disclosure:
H. Houzen has received funding for travel and/or speaker honoraria from Biogen, Mitsubishi Tanabe Pharma Corporation, and Takeda Pharmaceutical Company.
H.Sato and K. Kondo reports no disclosures.
M. Niino has received funding for travel and/or speaker honoraria from Biogen, Mitsubishi Tanabe Pharma Corporation, and Takeda Pharmaceutical Company; is part of a scientific advisory board for Biogen and Chugai Pharmaceutical Company; and has received research support from Grants-in-Aid for Scientific Research from the Ministry of Health, Labor and Welfare of Japan.