The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark/Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Mult Scler. 2022 Dec;28(14):2190-2201. doi: 10.1177/13524585221110582. Epub 2022 Jul 13.
The course of multiple sclerosis (MS) appears to be milder in recent decades.
To investigate how time from onset to disability milestones and how demographic and clinical characteristics have changed through subsequent onset cohorts of patients with MS.
In the nationwide Danish Multiple Sclerosis Registry, we have registered all 13,562 Danish patients with onset of MS or clinically isolated syndrome from 1996 through 2020. For the analyses of prognosis, we used all cases with relapsing onset ( = 11,669). After stratification into 5-year onset cohorts, we computed the hazard ratios for disability endpoints for all cohorts having at least 10 years of follow-up and the oldest 1996-2000 onset cohort as reference.
Patients in more recent MS onset cohorts have a shorter diagnostic delay and more of them start disease-modifying treatment within 1 year since diagnosis. The prognosis was better for later onset cohorts. For the 2001-2005 cohort, the hazard ratio for confirmed Expanded Disability Status Scale (EDSS) 4 was 0.85 (95% confidence interval (CI), 0.76-0.95) and for confirmed EDSS 6: 0.76 (95% CI, 0.65-0.88). For the more recent 2006-2010 cohort, the corresponding hazard ratios were 0.70 (95% CI, 0.62-0.79) and 0.60 (95% CI, 0.50-0.71).
We observed a considerable improvement of the prognosis in recent onset cohorts of relapsing-onset MS.
多发性硬化症（MS）的病程在近几十年来似乎较为缓和。
探究在后续发病的 MS 患者队列中，从发病到残疾里程碑的时间以及人口统计学和临床特征是如何变化的。
在全国性的丹麦多发性硬化症登记处，我们登记了 1996 年至 2020 年期间所有 13562 名丹麦 MS 或临床孤立综合征患者的发病情况。为了分析预后，我们使用了所有复发性发病的病例（n=11669）。在分层为 5 年发病队列后，我们计算了所有至少有 10 年随访时间的队列的残疾终点的风险比，并以最早的 1996-2000 年发病队列作为参考。
发病时间较晚的 MS 患者队列的诊断延迟时间更短，且有更多的患者在诊断后 1 年内开始使用疾病修正治疗。较晚发病的队列预后更好。对于 2001-2005 年发病队列，经确认的扩展残疾状况量表（EDSS）4 的风险比为 0.85（95%置信区间（CI），0.76-0.95），经确认的 EDSS 6 的风险比为 0.76（95% CI，0.65-0.88）。对于更近的 2006-2010 年发病队列，相应的风险比分别为 0.70（95% CI，0.62-0.79）和 0.60（95% CI，0.50-0.71）。
我们观察到复发性 MS 近期发病队列的预后有显著改善。
