MS on the Up

M

Estimating the prevalence of multiple sclerosis using 56.6 million electronic health records from the United States. Briggs FB, Hill E. Mult Scler. 2019 Jul 24:1352458519864681

BACKGROUND/OBJECTIVE: In 2019, the 2010 U.S. multiple sclerosis (MS) prevalence was robustly estimated (265.1-309.2/100,000) based on large administrative health-claims datasets. Using 56.6 million electronic health records (EHRs), we sought to generate complementary age, sex, and race standardized estimates.

METHODS/RESULTS: Using de-identified EHRs and 2018 U.S. Census data, we estimated an age- and sex-standardized MS prevalence of 219.5/100,000 which increased to 274.5/100,000 when accounting for White and Black race alone. Women aged 50 to 69 years had the highest prevalence (>600/100,000). Among White and Black Americans, the age- and sex-standardized prevalence was 283.7 and 226.1 per 100,000, respectively.

CONCLUSION: Using 56.6 million EHRs and standardizing for age, sex, and race (White and Black Americans only), we estimated at least 810,504 Americans were living with MS in 2018.

If correct this would suggest the occurence of MS in the US is double. I’m not bright enough to determine where the holes of the approach are Also look at Australia

Change in multiple sclerosis prevalence over time in Australia 2010-2017 utilising disease-modifying therapy prescription data. Campbell JA, Simpson S Jr, Ahmad H, Taylor BV, van der Mei I, Palmer AJ. Mult Scler. 2019 Jul 26:1352458519861270.

OBJECTIVE: Determine the prevalence of multiple sclerosis (MS) in Australia in 2017 using MS-specific disease-modifying therapy (DMT) prescription data and estimate the change in prevalence from 2010.

METHODS: DMT prescriptions were extracted from Australia’s Pharmaceutical Benefits Scheme (PBS) data for January-December 2017. Percentages of people with MS using DMTs (DMT penetrance) were calculated using data from the Australian MS Longitudinal Study. Prevalence was estimated by dividing the total number of monthly prescriptions by 12 (except alemtuzumab), adjusted for DMT penetrance and Australian population estimates. Prevalences in Australian states/territories were age-standardised to the Australian population. Comparisons with 2010 prevalence data were performed using Poisson regression.

RESULTS: Overall DMT penetrance was 64%, and the number of people with MS in Australia in 2017 was 25,607 (95% confidence interval (CI): 24,874-26,478), a significant increase of 4324 people since 2010 (p < 0.001). The prevalence increased significantly from 95.6/100,000 (2010) to 103.7/100,000 (2017), with estimates highest in Tasmania in 2017 (138.7/100,000; 95% CI: 137.2-140.1) and lowest in Queensland (74.6/100,000; 95% CI: 73.5-75.6). From 2010 to 2017 using the median latitudes for each state/territory, the overall latitudinal variation in MS prevalence was an increase of 3.0% per degree-latitude.

CONCLUSION: Consistent with global trends, Australia’s MS prevalence has increased; this probably reflecting decreased mortality, increased longevity and increased incidence.

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