1
|
Luetic GG, Menichini ML, Vrech C, Pappolla A, Patrucco L, Cristiano E, Marrodán M, Ysrraelit MC, Fiol M, Correale J, Cohen L, Alonso R, Silva B, Casas M, Garcea O, Deri N, Burgos M, Liwacki S, Tkachuk V, Barboza A, Piedrabuena R, Blaya P, Steinberg J, Martínez A, Carrá A, Tavolini D, López P, Knorre E, Nofal P, Volman G, Carnero Contentti E, Pinheiro AA, Leguizamon F, Silva E, Hryb J, Balbuena ME, Zanga G, Kohler M, Chertcoff A, Lazaro L, Tizio S, Mainela C, Reich E, Recchia L, Blanche J, Marcilla MP, Fracaro ME, Sgrilli G, Divi P, Jacobo M, Cabrera M, Pagani Cassara F, Sinay V, Curbelo C, Míguez J, Coppola M, Liguori NF, Martos I, Pettinicchi JP, Viglione JP, José G, Bestoso S, Manzi R, Vázquez G, Nadur D, Martínez C, Serena MA, Rojas JI. Clinical and demographic characteristics of male MS patients included in the national registry-RelevarEM. Does sex or phenotype make the difference in the association with poor prognosis? Mult Scler Relat Disord 2022; 58:103401. [PMID: 35216784 DOI: 10.1016/j.msard.2021.103401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/27/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In multiple sclerosis demographics there is a well-known female prevalence and male patients have been less specifically evaluated in clinical studies, though some clinical differences have been reported between sexes. OBJECTIVE The objective of this study was to assess clinical and demographic differences between male and female patients included in the national Argentine MS Registry-RelevarEM. MATERIAL AND METHODS This study was observational, retrospective, and was based on the data of 3099 MS patients included as of 04 April 2021. The statistical analysis plan included bivariate analyses with the crude data and also after adjustment for the MS phenotype, further categorized as progressive-onset MS or relapsing-onset MS. In the adjusted analysis, the Mantel-Haenszel odds ratio was compared to the crude odds ratio, to account for the phenotype as a confounder. RESULTS The data from 1,074 (34.7%) men and 2,025 (65.3%) women with MS diagnosis were analysed. Males presented primary progressive disease two times more often than women (11% and 5%, respectively). In the crude analyses by sex, the presence of exclusively infratentorial lesions in the magnetic resonance imaging studies was more frequent in males than in females, but after adjustment by MS onset phenotype, such difference was only present in males with relapsing-onset MS (p = 0.00006). Similarly, worse Expanded Disability Status Scale scores were confirmed only in men with relapsing-onset disease after phenotype adjustment (p = 0.02). CONCLUSION We did not find any statistically significant clinical or demographic difference between sexes when the progressive MS phenotype was specifically considered. However, the differences we found between the clinical phenotypes are in line with the literature and highlight the importance of stratifying the analyses by sex and phenotype when designing MS studies.
Collapse
Affiliation(s)
- Geraldine G Luetic
- Instituto de Neurociencias de Rosario, San Lorenzo, Rosario, Santa Fe 3598, Argentina.
| | - María Laura Menichini
- Instituto de Neurociencias de Rosario, San Lorenzo, Rosario, Santa Fe 3598, Argentina; Sanatorio Británico, Rosario, Santa Fe, Argentina
| | - Carlos Vrech
- Departamento de Enfermedades desmielinizantes, Sanatorio Allende, Córdoba, Argentina
| | | | | | | | | | | | - Marcela Fiol
- Departamento de Neurología, FLENI, CABA, Argentina
| | | | - Leila Cohen
- Hospital Ramos Mejía, Centro Universitario de Esclerosis Múltiple, CABA, Argentina
| | - Ricardo Alonso
- Hospital Ramos Mejía, Centro Universitario de Esclerosis Múltiple, CABA, Argentina
| | - Berenice Silva
- Hospital Ramos Mejía, Centro Universitario de Esclerosis Múltiple, CABA, Argentina
| | - Magdalena Casas
- Hospital Ramos Mejía, Centro Universitario de Esclerosis Múltiple, CABA, Argentina
| | - Orlando Garcea
- Hospital Ramos Mejía, Centro Universitario de Esclerosis Múltiple, CABA, Argentina
| | - Norma Deri
- Centro de Investigaciones Diabaid, CABA, Argentina
| | - Marcos Burgos
- Servicio de Neurología, Hospital San Bernardo, Salta, Argentina
| | - Susana Liwacki
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina; Servicio de Neurología, Hospital Córdoba, Córdoba, Argentina
| | - Verónica Tkachuk
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología, Hospital de Clínicas José de San Martín, CABA, Argentina
| | | | - Raúl Piedrabuena
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina; Instituto Lennox, Córdoba, Argentina
| | | | - Judith Steinberg
- Sección de Enfermedades Desmielinizantes, Hospital Británico, CABA, Argentina
| | - Alejandra Martínez
- Sección de Enfermedades Desmielinizantes, Hospital Británico, CABA, Argentina; Hospital Nacional Alejandro Posadas, El Palomar, Buenos Aires, Argentina
| | - Adriana Carrá
- Sección de Enfermedades Desmielinizantes, Hospital Británico, CABA, Argentina; Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | | | - Pablo López
- Department of Neurosciences, Neuroimmunology Unit, Hospital Alemán, Buenos Aires, Argentina
| | - Eduardo Knorre
- Hospital de Agudos, Dr. Teodoro Álvarez, CABA, Argentina
| | - Pedro Nofal
- Hospital de Clínicas Nuestra Señora del Carmen, Tucumán, Argentina
| | - Gabriel Volman
- Hospital Pte. Perón, Avellaneda, Buenos Aires, Argentina
| | | | | | | | | | - Javier Hryb
- Servicio de Neurología, Hospital Carlos G Durand, Buenos Aires, Argentina
| | - María Eugenia Balbuena
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología, Hospital de Clínicas José de San Martín, CABA, Argentina
| | - Gisela Zanga
- Departamento de Neurología, Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Matías Kohler
- Axis Neurociencias, Bahía Blanca, Buenos Aires, Argentina
| | - Aníbal Chertcoff
- Sección de Enfermedades Desmielinizantes, Hospital Británico, CABA, Argentina
| | | | | | | | - Edgardo Reich
- Instituto Médico Especializado, Buenos Aires, Argentina
| | | | - Jorge Blanche
- IRNEC (Instituto Regional de Neurociencias), San Miguel de Tucumán, Tucumán, Argentina
| | | | | | | | - Pablo Divi
- RIAPEM (Red Integral Asistencial al Paciente con Esclerosis Múltiple), Santiago del Estero, Argentina
| | - Miguel Jacobo
- RIAPEM (Red Integral Asistencial al Paciente con Esclerosis Múltiple), Santiago del Estero, Argentina
| | | | | | - Vladimiro Sinay
- Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - Celeste Curbelo
- Policlínico Municipal Sofía T. de Santamarina, Buenos Aires, Argentina
| | | | | | - Nora Fernández Liguori
- Sanatorio Güemes, Buenos Aires, Argentina; Hospital Enrique Tornú, Buenos Aires, Argentina
| | - Iván Martos
- Clínica San Jorge, Ushuaia, Tierra del fuego, Argentina
| | - Juan Pablo Pettinicchi
- Department of Neurosciences, Neuroimmunology Unit, Hospital Alemán, Buenos Aires, Argentina
| | | | - Gustavo José
- Sección de enfermedades desmielinizantes, Servicio de Neurología, Hospital Padilla, Tucumán, Argentina
| | - Santiago Bestoso
- Servicio Neurología, Hospital Escuela José F. de San Martín Corrientes, Corrientes, Argentina
| | | | - Guido Vázquez
- Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - Débora Nadur
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología, Hospital de Clínicas José de San Martín, CABA, Argentina
| | | | | | - Juan I Rojas
- Centro de esclerosis múltiple de Buenos Aires, CABA, Argentina; Servicio de Neurología, Hospital Universitario de CEMIC, CABA, Argentina
| |
Collapse
|