Zabol university of medical sciences, Zabol, Iran.
Student's Scientific research center, Tehran University of Medical Sciences, Tehran, Iran.
BMC Neurol. 2023 Sep 4;23(1):316. doi: 10.1186/s12883-023-03332-1.
Menopause is a physiologic phase in women's lives. Findings regarding multiple sclerosis (MS) course through menopause are diverse. So, we designed this systematic review and meta-analysis to estimate the impact of menopause on relapse rate, and disability status in women with MS.
PubMed, Scopus, EMBASE, Web of Science, and google scholar were systematically searched by two independent researchers on January 1st, 2023. They also evaluated conference abstracts, and references of the included studies. In addition, data regarding the total number of participants, name of the first author of the publication, publication year, country of origin, disease duration, disease type, annual relapse rate, and Expanded Disability Status Scale (EDSS) before and after menopause were recorded.
A literature search revealed 1024 records. Twenty-one full texts were evaluated, and finally, four studies were included for meta-analysis. Mean ARR before menopause ranged between 0.21 and 0.37, and after menopause ranged between 0.13 and 0.08. The SMD of mean ARR ranged between - 1.04, and - 0.29, while the pooled SMD was estimated as -0.52(95% CI: -0.88, -0.15) (I = 73.6%, P = 0.02). The mean EDSS before menopause ranged between 1.5 and 2, and after menopause ranged between 2 and 3.1. The SMD of EDSS ranged between 0.46, and 0.71. The pooled SMD of EDSS change (after menopause-before menopause) estimated as 0.56(95% CI: 0.38, 0.73)(I = 0, P = 0.4).
The result of this systematic review and meta-analysis show that menopause can be associated with relapse rate reduction, unlike increase in disease-related disability in women with MS.
绝经是女性生命中的一个生理阶段。关于多发性硬化症（MS）病程通过绝经的研究结果各不相同。因此，我们设计了这项系统评价和荟萃分析，以评估绝经对多发性硬化症女性复发率和残疾状况的影响。
两位独立研究人员于 2023 年 1 月 1 日系统地检索了 PubMed、Scopus、EMBASE、Web of Science 和谷歌学术，并评估了纳入研究的会议摘要和参考文献。此外，还记录了有关参与者总数、出版物第一作者姓名、出版年份、原籍国、疾病持续时间、疾病类型、年复发率以及绝经前后扩展残疾状况量表（EDSS）的数据。
文献检索显示有 1024 条记录。评估了 21 篇全文，最终纳入了 4 项研究进行荟萃分析。绝经前平均 ARR 范围在 0.21 至 0.37 之间，绝经后范围在 0.13 至 0.08 之间。平均 ARR 的 SMD 范围在-1.04 至-0.29 之间，而合并的 SMD 估计为-0.52（95%CI：-0.88，-0.15）（I=73.6%，P=0.02）。绝经前平均 EDSS 范围在 1.5 至 2 之间，绝经后范围在 2 至 3.1 之间。EDSS 的 SMD 范围在 0.46 至 0.71 之间。EDSS 变化（绝经后-绝经前）的合并 SMD 估计为 0.56（95%CI：0.38，0.73）（I=0，P=0.4）。
这项系统评价和荟萃分析的结果表明，绝经与多发性硬化症女性复发率降低有关，而不是疾病相关残疾的增加。
