Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Possible Delayed Diagnoses in Younger Patients, Men

Neurology; ePub 2018 Mar 16; Rotstein, Chen, et al

In a large, population-based multiple sclerosis (MS) cohort, researchers found stable incidence and increasing prevalence of MS. Furthermore, a spike in incidence in 2010 among younger patients and men at a time of widespread media coverage of MS suggests that these groups may be vulnerable to delayed diagnosis. Researchers identified MS cases from 1996 to 2013 by applying a validated algorithm to health administrative data. They found:

  • The prevalence of MS increased by 69% from 1.57 per 1,000 in 1996 (n=12,155) to 2.65 in 2013 (n=28,192).
  • Incidence remained relatively stable except for a spike in 2010, followed by a subsequent decline in 2011–2013, particularly among young people and men.
  • Mortality decreased by 33% from 26.7 per 1,000 to 18.0 per 1,000.
  • The incidence sex ratio was stable from 1996 to 2009, then declined in 2010, with partial rebound by 2013.

Rotstein DL, Chen H, Wilton AS, et al. Temporal trends in multiple sclerosis prevalence and incidence in a large population. [Published online ahead of print March 16, 2018]. Neurology. doi:10.1212/WNL.0000000000005331.

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