Multiple sclerosis soars in women in the 21st century while it stagnates in men

Three out of four cases of multiple sclerosis are diagnosed in women. While there is already a more than noticeable imbalance between the sexes, the trend seems to continue, mainly due to the evolution of women’s lifestyles over the last half century.

“We have seen that the incidence in men is the same as in the 1950s,” he commented. Celia Oreja Guevara, head of the Neurology Section at the San Carlos Clinical Hospital. “Among women, on the other hand, it has increased by at least 15 to 20 percent.”

These data come from the most comprehensive Danish disease registers. The highest incidence of multiple sclerosis in women, it’s not unusual in autoimmune diseases “and it seems to have to do with the sex hormone, although its role isn’t very clear.”

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The causes of the increase in women are clearer: their increasing tobacco consumption in recent decades, the lack of vitamin D (due to less exposure to the sun), a more sedentary life, a poorer diet…”Having a healthy life is very important for multiple sclerosis‘ said the doctor.

Celia Oreja-Guevara participated in the presentation of a new drug for the most common form of the disease, relapsing-remitting multiple sclerosis. This is Ponesimod, developed by Janssen and approved by the Optimum study, in which its effectiveness was measured against one of the standard treatments for the disease, teriflunomide.

The head of the neurology department at Vall d’Hebron University Hospital in Barcelona, Xavier Montalbanwho also participated in the presentation, explained that among the results are a 30% reduction in the annual rate of outbreaks and a 56% decrease in the number of new active lesions detected by resonance.

In addition, “this is the first time that an immunomodulatory drug has shown an effect on common fatigue”, one of the so-called invisible symptoms of the disease. Blurry vision or low sensitivity in the extremities are easier to identify, but there are others that are invisible.

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Fatigue is one of them and is observed in 75% of patients, but there are also cognitive disorders such as confusion and reduced ability to process tasks. These symptoms can affect work: only 50% of MS patients of working age do so. Among them, only half work full time.

First line of treatment

Oreja-Guevara and Montalbán agree that the new drug can be positioned as one of the first treatment options for relapsing-remitting multiple sclerosis, changing the current strategy.

“Before we thought that the most effective drugs had more side effects and were more expensive“, indicated the neurologist. “Now we are breaking this dogma”. The therapy started with ineffective treatments to evolve, as the degeneration progresses, towards more effective treatments, but also with more side effects. important.

“There are already studies that show that if you start with very effective treatments early on, there will be less disease progression, fewer relapses and better quality of life in patients with poor prognoses.”

Montalbán, for his part, pointed out an exception: “The only [pacientes] The ones I might not recommend forponesimod are girls who want to get pregnant: there doesn’t seem to be an increase in the abortion rate with its use, but it’s safer to do so.”

In the presentation of the drug was present Jose Miguel Lainezhead of neurology at the University Clinical Hospital of Valencia and president of the Spanish Society of Neurology, who recalled that “neurodegenerative diseases are almost an epidemic in our society”, but that pharmaceutical research over the past 20 years has radically changed the landscape.

In this regard, Montalbán said that immunology is creeping into this area, where “we have a black hole in this sense”, which will have an impact on the understanding and management of these diseases.

The foundation stone for multiple sclerosis was laid by a study published this year which links its appearance to the Epstein-Barr virus, which causes mononucleosis, a very common infection. In fact, some multiple sclerosis drugs are thought to be effective because they eliminate the virus from its reservoirs. However, Dr Oreja-Guevara reminded that only a minority of women with this virus will develop the disease.

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