Ribbons Karen Ann, McElduff Patrick, Boz Cavit, Trojano Maria, Izquierdo Guillermo, Duquette Pierre, Girard Marc, Grand'Maison Francois, Hupperts Raymond, Grammond Pierre, Oreja-Guevara Celia, Petersen Thor, Bergamaschi Roberto, Giuliani Giorgio, Barnett Michael, van Pesch Vincent, Amato Maria-Pia, Iuliano Gerardo, Fiol Marcela, Slee Mark, Verheul Freek, Cristiano Edgardo, Fernandez-Bolanos Ricardo, Saladino Maria-Laura, Rio Maria Edite, Cabrera-Gomez Jose, Butzkueven Helmut, van Munster Erik, Den Braber-Moerland Leontien, La Spitaleri Daniele, Lugaresi Alessandra, Shaygannejad Vahid, Gray Orla, Deri Norma, Alroughani Raed, Lechner-Scott Jeannette
John Hunter Hospital, Newcastle, Australia.
University of Newcastle, Newcastle, Australia.
PLoS One. 2015 Jun 5;10(6):e0122686. doi: 10.1371/journal.pone.0122686. eCollection 2015.
Multiple Sclerosis is more common in women than men and females have more relapses than men. In a large international cohort we have evaluated the effect of gender on disability accumulation and disease progression to determine if male MS patients have a worse clinical outcome than females.
Using the MSBase Registry, data from 15,826 MS patients from 25 countries was analysed. Changes in the severity of MS (EDSS) were compared between sexes using a repeated measures analysis in generalised linear mixed models. Kaplan-Meier analysis was used to test for sex difference in the time to reach EDSS milestones 3 and 6 and the secondary progressive MS.
In relapse onset MS patients (n = 14,453), males progressed significantly faster in their EDSS than females (0.133 vs 0.112 per year, P<0.001,). Females had a reduced risk of secondary progressive MS (HR (95% CI) = 0.77 (0.67 to 0.90) P = 0.001). In primary progressive MS (n = 1,373), there was a significant increase in EDSS over time in males and females (P<0.001) but there was no significant sex effect on the annualized rate of EDSS change.
Among registrants of MSBase, male relapse-onset patients accumulate disability faster than female patients. In contrast, the rate of disability accumulation between male and female patients with primary progressive MS is similar.
多发性硬化症在女性中比男性更常见，且女性比男性有更多的复发。在一个大型国际队列中，我们评估了性别对残疾累积和疾病进展的影响，以确定男性多发性硬化症患者的临床结局是否比女性更差。
使用MSBase注册库，分析了来自25个国家的15826例多发性硬化症患者的数据。在广义线性混合模型中使用重复测量分析比较两性之间多发性硬化症严重程度（扩展残疾状态量表，EDSS）的变化。使用Kaplan-Meier分析来检验达到EDSS里程碑3和6以及继发进展型多发性硬化症的时间上的性别差异。
在复发型多发性硬化症患者（n = 14453）中，男性的EDSS进展明显比女性快（每年0.133对0.112，P<0.001）。女性继发进展型多发性硬化症的风险降低（风险比（95%置信区间）= 0.77（0.67至0.90），P = 0.001）。在原发进展型多发性硬化症患者（n = 1373）中，男性和女性的EDSS随时间均有显著增加（P<0.001），但性别对EDSS年化变化率没有显著影响。
在MSBase的注册者中，复发型男性患者比女性患者更快地累积残疾。相比之下，原发进展型多发性硬化症的男性和女性患者之间的残疾累积率相似。
