Abstract
The objective of this study was to describe and compare the baseline epidemiological data of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients included in RelevarEM (Clinical Trials registry number NCT03375177).
Methods
RelevarEM is a longitudinal, strictly observational MS and NMOSD registry in Argentina. Epidemiological and comorbidity data from MS and NMOSD patients were described and compared. For comorbidities, the Charlson comorbidity index (CCI) was used to calculate the burden at entry. CCI was stratified in 0 and ≥ 1 and described for the entire cohort.
Results
A total of 1588 and 75 MS and NMOSD patients (respectively) were included. For MS patients, the mean age was 42 ± 7 years, female sex 65.3%, mean EDSS 2, and mean disease duration 8 ± 6 years. In NMOSD, the mean age was 40 ± 7 years, female sex 78.7%, mean disease duration 5 ± 3.5 years, and mean EDSS 2.5. The most frequent MS phenotype was RRMS in 82.4%. In MS, the CCI was 0 in 85.8.2% while ≥ 1 was in 14.2% of patients. Regarding phenotype stratification, CCI ≥ 1 was 3.9% in CIS, 13.5% in RRMS, 28.7% in SPMS, and 17.4% in PPMS (p < 0.001 between groups). In NMOSD, the CCI was 0 in 64% while ≥ 1 was in 36%. The MS/NMOSD ratio found was 21/1.
Conclusions
This is the first analysis of the longitudinal Argentinean registry of MS and NMOSD describing and comparing conditions that contributes to provide reliable real-world data in the country.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cristiano E, Patrucco L, Rojas JI (2008) A systematic review of the epidemiology of multiple sclerosis in South America. Eur J Neurol 15(12):1273–1278
Cristiano E, Rojas J, Romano M, Frider N, Machnicki G, Giunta D, Calegaro D, Corona T, Flores J, Gracia F, Macias-Islas M, Correale J (2013) The epidemiology of multiple sclerosis in Latin America and the Caribbean: a systematic review. Mult Scler 19(7):844–854
Kurtzke JF (2000) Epidemiology of multiple sclerosis. Does this really point toward an etiology? Lectio Doctoralis. Neurol Sci 21(6):383–403
Kurtzke JF (2005) Epidemiology and etiology of multiple sclerosis. Phys Med Rehabil Clin N Am 16(2):327–349
Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, Correale J, Fazekas F, Filippi M, Freedman MS, Fujihara K, Galetta SL, Hartung HP, Kappos L, Lublin FD, Marrie RA, Miller AE, Miller DH, Montalban X, Mowry EM, Sorensen PS, Tintoré M, Traboulsee AL, Trojano M, Uitdehaag BMJ, Vukusic S, Waubant E, Weinshenker BG, Reingold SC, Cohen JA (2018) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 17(2):162–173
Wingerchuk DM, Banwell B, Bennett JL et al (2015) International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85(2):177–189
Rojas JI, Carra A, Correale J et al (2019) The Argentinean multiple sclerosis registry (RelevarEM): methodological aspects and directions. Mult Scler Relat Disord 32:133–137
Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland H, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald criteria”. Ann Neurol 58(6):840–846
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O’Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302
Drucker E, Vermund SH (1989) Estimating population prevalence of human immunodeficiency virus infection in urban areas with high rates of intravenous drug use: a model of the Bronx in 1988. Am J Epidemiol 130(1):133–142
Levy M, Mealy M, Jarius S et al (2015) New acute severity scale for neuromyelitis optica relapses (P5.249). Neurology 84(14 Supplement):P5.249
Mellinger S, Dias D, Flores N et al (2018) Multiple sclerosis prevalence in Salta City, Argentina. Mult Scler Relat Disord 25:212–215
Cristiano E, Patrucco L, Miguez J, Giunta D, Peroni J, Rojas JI (2016) Increasing incidence of multiple sclerosis among women in Buenos Aires: a 22 year health maintenance organization based study. Neurol Sci 37(10):1621–1626
Cristiano E, Patrucco L, Miguez J, Giunta D, Correale J, Fiol M, Ysrraelit MC, Cáceres F, Liguori NF, Saladino ML, Garcea O, Silva B, Alonso R, Carrá A, Curbelo MC, Martinez A, Steinberg J, Giachello S, Melcom MO, Rojas JI (2016) Increasing prevalence of multiple sclerosis in Buenos Aires, Argentina. Mult Scler Relat Disord 9:91–94
Rojas JI, Patrucco L, Cristiano E (2012) Multiple sclerosis in Argentina. Systematic review and meta-analysis. Medicina (B Aires) 72(6):449–454
Ebers GC (2008) Environmental factors and multiple sclerosis. Lancet Neurol 7(3):268–277
Ascherio A, Munger KL (2007) Environmental risk factors for multiple sclerosis. Part I: the role of infection. Ann Neurol 61(4):288–299
Bach JF (2002) The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 347(12):911–920
Strachan DP (1989) Hay fever, hygiene, and household size. BMJ 299(6710):1259–1260
Rivera JF, Kurtzke JF, Booth VJ, Corona VT (2008) Characteristics of Devic’s disease (neuromyelitis optica) in Mexico. J Neurol 255(5):710–715
Correale J, Farez M (2007) Association between parasite infection and immune responses in multiple sclerosis. Ann Neurol 61(2):97–108
Melcon M, Gold L, Carra A et al (2008) Argentine Patagonia: prevalence and clinical features of multiple sclerosis. Mult Scler 14(5):656–662
Trojano M, Tintore M, Montalban X et al (2017) Treatment decisions in multiple sclerosis - insights from real-world observational studies. Nat Rev Neurol 13(2):105–118
Kalincik T, Butzkueven H (2016) Observational data: understanding the real MS world. Mult Scler 22(13):1642–1648
Jacobs LD, Wende KE, Brownscheidle CM et al (1999) A profile of multiple sclerosis: the New York State Multiple Sclerosis Consortium. Mult Scler 5(5):369–376
Vukusic S, Casey R, Rollot F, et al. (2018) Observatoire Francais de la Sclerose en Plaques (OFSEP): a unique multimodal nationwide MS registry in France. Mult Scler 1352458518815602
Koch-Henriksen N (1999) The Danish Multiple Sclerosis Registry: a 50-year follow-up. Mult Scler 5(4):293–296
Murley C, Friberg E, Hillert J, Alexanderson K, Yang F (2019) Validation of multiple sclerosis diagnoses in the Swedish National Patient Register. Eur J Epidemiol
Tremlett H, Yousefi M, Devonshire V, Rieckmann P, Zhao Y, Neurologists UBC (2009) Impact of multiple sclerosis relapses on progression diminishes with time. Neurology 73(20):1616–1623
Trojano M, Bergamaschi R, Amato MP et al (2019) The Italian multiple sclerosis register. Neurol Sci 40(1):155–165
Glaser A, Stahmann A, Meissner T, Flachenecker P, Horáková D, Zaratin P, Brichetto G, Pugliatti M, Rienhoff O, Vukusic S, de Giacomoni AC, Battaglia MA, Brola W, Butzkueven H, Casey R, Drulovic J, Eichstädt K, Hellwig K, Iaffaldano P, Ioannidou E, Kuhle J, Lycke K, Magyari M, Malbaša T, Middleton R, Myhr KM, Notas K, Orologas A, Otero-Romero S, Pekmezovic T, Sastre-Garriga J, Seeldrayers P, Soilu-Hänninen M, Stawiarz L, Trojano M, Ziemssen T, Hillert J, Thalheim C (2019) Multiple sclerosis registries in Europe - an updated mapping survey. Mult Scler Relat Disord 27:171–178
Flachenecker P, Buckow K, Pugliatti M, Kes VB, Battaglia MA, Boyko A, Confavreux C, Ellenberger D, Eskic D, Ford D, Friede T, Fuge J, Glaser A, Hillert J, Holloway E, Ioannidou E, Kappos L, Kasilingam E, Koch-Henriksen N, Kuhle J, Lepore V, Middleton R, Myhr KM, Orologas A, Otero S, Pitschnau-Michel D, Rienhoff O, Sastre-Garriga J, Schyns-Liharska T, Sutovic D, Thalheim C, Trojano M, Vlasov YV, Yaldizli O, EUReMS Consortium (2014) Multiple sclerosis registries in Europe - results of a systematic survey. Mult Scler 20(11):1523–1532
Rojas JI, Patrucco L, Trojano M et al (2015) Multiple sclerosis in Latin America: a different disease course severity? A collaborative study from the MSBase Registry. Mult Scler J Exp Transl Clin 1:2055217315600193
Funding
Irrestrictive research grants from Biogen Argentina, Genzyme Argentina, Merck Argentina, Novartis Argentina, and Roche Argentina allowed the development and implementation of the Registry. Those grants did not interfere in the development plan, variables, PI selection, patient information nor other aspects of the Registry.
Author information
Authors and Affiliations
Consortia
Corresponding author
Ethics declarations
The project was approved by the Ethics Committee of every principal investigator involved in the study.
Conflict of interest
Authors declare no conflict of interest with the research done.
Research involving human participants and/or animals
None.
Informed consent
None.
Ethical approval
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Rojas, J.I., Alonso Serena, M., Garcea, O. et al. Multiple sclerosis and neuromyelitis optica spectrum disorders in Argentina: comparing baseline data from the Argentinean MS Registry (RelevarEM). Neurol Sci 41, 1513–1519 (2020). https://doi.org/10.1007/s10072-019-04230-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-019-04230-6