Iaquinto Stefania, Chan Andrew, Manjaly Zina-Mary, Stanikić Mina, Ineichen Benjamin Victor, Kuhle Jens, Haag Christina, Müller Jannis, Yaldizli Özgür, Kamm Christian Philipp, Calabrese Pasquale, Zecca Chiara, Magnusson Tomas, Ammann Sabin, Kesselring Jürg, Baum Claudia, Kaminski Miriam, Puhan Milo Alan, von Wyl Viktor
Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland,
Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Neuroepidemiology. 2024 Nov 18:1-10. doi: 10.1159/000542632.
Understanding the prevalence of multiple sclerosis (MS) provides information for healthcare planning and helps identify trends and patterns of disease occurrence. For Switzerland, the number of persons with MS (pwMS) was last estimated at approximately 15,000 in 2016. The study's objectives were to update estimates of MS prevalence and characterise the change in MS prevalence in Switzerland between 2016 and 2021, the last year with complete administrative data.
The Swiss MS Registry (SMSR) is an ongoing, longitudinal study in Switzerland. It has previously established a methodology to assess the epidemiology of MS in Switzerland by integrating SMSR data with administrative data on reimbursement approvals for disease-modifying therapies (DMTs). Subsequently, the benchmark-multiplier method is applied to the combined data. Using the same methodology, we calculated overall and sex- and age-specific prevalence rates for 2021. Furthermore, we descriptively analysed changes since 2016 by comparing the prevalence figures and demographic and clinical characteristics of pwMS in both years.
We estimated the population of pwMS in Switzerland at 18,140 (95% simulation interval: 17,550-18,750), corresponding to a period prevalence of 200.8-214.5/100,000 inhabitants. Peak prevalence was observed in the 50- to 55-year age group. Compared to 2016, the 2021 estimate corresponds to a 20% increase (n = 3,000). Extrapolating from Swiss population growth, we estimated that one-fifth of the observed prevalence increase may be attributed to a rising population. The proportion of pwMS in the age range from 50 to 64 (32.5% vs. 35.9%) and above 65 (8.0% vs. 11.1%) years increased. Consequently, the median (interquartile range) age increased from 47 (37-55) to 49 (38-57) years. The median age at diagnosis (36 [28-45] years) and the female-to-male ratio (2.7:1) remained stable since 2016. The proportion of pwMS treated with DMTs increased from 62.1% to 69.0%, with the largest change observed in infusion therapies (15.7% vs. 23.3%).
The estimated MS prevalence in Switzerland has increased since the previous estimate in 2016, with a shift in peak prevalence towards older ages. Population growth explained around one-fifth of this increase, thus leaving room for contributions by additional factors, which require further investigation. The rising MS prevalence has several implications for healthcare, research, and society.
了解多发性硬化症(MS)的患病率可为医疗规划提供信息,并有助于识别疾病发生的趋势和模式。在瑞士,2016年最后一次估计MS患者人数约为15,000人。本研究的目的是更新MS患病率的估计值,并描述2016年至2021年(有完整行政数据的最后一年)瑞士MS患病率的变化情况。
瑞士MS注册研究(SMSR)是瑞士一项正在进行的纵向研究。此前,该研究已建立了一种方法,通过将SMSR数据与疾病修饰疗法(DMT)报销批准的行政数据相结合,来评估瑞士MS的流行病学情况。随后,将基准乘数法应用于合并后的数据。我们使用相同的方法计算了2021年的总体患病率以及按性别和年龄划分的患病率。此外,我们通过比较这两年MS患者的患病率数据以及人口统计学和临床特征,对2016年以来的变化进行了描述性分析。
我们估计瑞士MS患者人数为18,140人(95%模拟区间:17,550 - 18,750),相当于期间患病率为200.8 - 214.5/10万居民。在50至55岁年龄组中观察到患病率峰值。与2016年相比,2021年的估计值增加了20%(n = 3,000)。根据瑞士人口增长情况进行推断,我们估计观察到的患病率增加中有五分之一可能归因于人口增长。50至64岁(32.5%对35.9%)和65岁以上(8.0%对11.1%)年龄组的MS患者比例有所增加。因此,年龄中位数(四分位间距)从47岁(37 - 55岁)增加到49岁(38 - 57岁)。自2016年以来,诊断时的年龄中位数(36岁[28 - 45岁])和女性与男性比例(2.7:1)保持稳定。接受DMT治疗的MS患者比例从62.1%增加到69.0%,其中输液疗法的变化最大(15.7%对23.3%)。
自2016年上次估计以来,瑞士MS患病率估计有所增加,患病率峰值向老年人群转移。人口增长解释了这一增长的约五分之一,因此其他因素仍有影响空间,需要进一步调查。MS患病率的上升对医疗、研究和社会有若干影响。