Late-onset multiple sclerosis in Iran: A report on demographic and disease characteristics.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 15 08 2022
revised: 26 12 2022
accepted: 28 12 2022
pubmed: 14 1 2023
medline: 15 3 2023
entrez: 13 1 2023
Statut: ppublish

Résumé

Today, it is estimated that around 5% of multiple sclerosis (MS) patients are in the late-onset category (age at disease onset ≥ 50). Diagnosis and treatment in this group could be challenging. Here, we report the latest update on the characteristics of Iranian patients with late-onset MS (LOMS). This cross-sectional study used the information provided by the nationwide MS registry of Iran (NMSRI). The registrars from 14 provinces entered data of patients with a confirmed diagnosis of MS by neurologists. Patients with disease onset at or later than 50 years of age were considered LOMS. Of 20,036 records, the late-onset category included 321 patients (1.6%). The age-standardized LOMS prevalence was around 75 per 100,000 people. 215 patients (67%) were female. Median Expanded Disability Status Scale (EDSS) was 3 (interquartile range: 1.5-5). The majority of the cases (56%) suffered from relapsing-remitting (RR) course while 20% were diagnosed with primary progressive (PP) MS. Significantly higher proportion of male sex, PPMS, and higher EDSS were seen in the late-onset group compared with early-onset and adult-onset cases (p-value < 0.05). Seventy-five (23%) patients did not receive any disease-modifying treatment. The more prominent degenerative pathology of LOMS may be the underlying mechanism of the observed differences in comparison to non-LOMS. There are substantial differences and knowledge gaps regarding LOMS which could be the subject of further research.

Sections du résumé

BACKGROUND BACKGROUND
Today, it is estimated that around 5% of multiple sclerosis (MS) patients are in the late-onset category (age at disease onset ≥ 50). Diagnosis and treatment in this group could be challenging. Here, we report the latest update on the characteristics of Iranian patients with late-onset MS (LOMS).
METHODS METHODS
This cross-sectional study used the information provided by the nationwide MS registry of Iran (NMSRI). The registrars from 14 provinces entered data of patients with a confirmed diagnosis of MS by neurologists. Patients with disease onset at or later than 50 years of age were considered LOMS.
RESULTS RESULTS
Of 20,036 records, the late-onset category included 321 patients (1.6%). The age-standardized LOMS prevalence was around 75 per 100,000 people. 215 patients (67%) were female. Median Expanded Disability Status Scale (EDSS) was 3 (interquartile range: 1.5-5). The majority of the cases (56%) suffered from relapsing-remitting (RR) course while 20% were diagnosed with primary progressive (PP) MS. Significantly higher proportion of male sex, PPMS, and higher EDSS were seen in the late-onset group compared with early-onset and adult-onset cases (p-value < 0.05). Seventy-five (23%) patients did not receive any disease-modifying treatment.
DISCUSSION CONCLUSIONS
The more prominent degenerative pathology of LOMS may be the underlying mechanism of the observed differences in comparison to non-LOMS.
CONCLUSION CONCLUSIONS
There are substantial differences and knowledge gaps regarding LOMS which could be the subject of further research.

Identifiants

pubmed: 36638768
pii: S2211-0348(22)00997-X
doi: 10.1016/j.msard.2022.104493
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104493

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of Competing Interests None.

Auteurs

Fereshteh Ghadiri (F)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Mohammad Ali Sahraian (MA)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Nazanin Razazian (N)

Department of Neurology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Fereshteh Ashtari (F)

Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Maryam Poursadeghfard (M)

Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Seyed Massood Nabavi (SM)

Department of Regenerative Medicine, Royan Institute for Stem Cell Technology and Biology, Tehran, Iran.

Samira Navardi (S)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Seyed Mohammad Baghbanian (SM)

Department of Neurology, Booalicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.

Vahid Shaygannejad (V)

Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Mohammad Hossein Harirchian (MH)

Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Nahid Beladimoghadam (N)

Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Nastaran Majdinasab (N)

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Samaneh Hosseini (S)

Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Amirreza Azimi (A)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Hoda Kamali (H)

Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Ehsan Sharifipour (E)

Department of Neurology, School of Medicine, Neuroscience Research Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.

Nahid Hosseini Nejad Mir (N)

Department of Internal Medicine, School of Medicine, Shohadaye Ashayer Hospital, Lorestan, University of Medical Sciences, Khorramabad, Iran.

Asghar Bayati (A)

Department of Neurology, Shahrekord University of Medical Sciences and Health Services, Shahrekord, Iran.

Mohammad Ali Nahayati (MA)

Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Hora Heidari (H)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Hossein Mozhdehipanah (H)

Department of Neurology, Qazvin University of Medical Sciences, Qazvin, Iran.

Hamidreza Ghalyanchi Langroodi (H)

Clinical Development and Research Unit of Ghaem Hospital, Gilan University of Medical Sciences, Rasht. Iran.

Nazanin Jalali (N)

Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

Saeideh Ayoubi (S)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Elnaz Asadollahzadeh (E)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Zahra Ebadi (Z)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Sharareh Eskandarieh (S)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: sh_eskandarieh@yahoo.com.

Abdorreza Naser Moghadasi (A)

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: abdorrezamoghadasi@gmail.com.

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