Systematic literature review and meta-analysis of the prevalence of secondary progressive multiple sclerosis in the USA, Europe, Canada, Australia, and Brazil

Background Secondary progressive multiple sclerosis (SPMS) is a subtype of multiple sclerosis (MS), which is a chronic neurological disease, characterised by inflammation of the central nervous system. Most of MS patients eventually progress to SPMS. This study estimates the prevalence of SPMS in th...

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Bibliographic Details
Published in:BMC neurology 2022-08, Vol.22 (1), p.1-301, Article 301
Main Authors: Vasanthaprasad, Vijayalakshmi, Khurana, Vivek, Vadapalle, Sreelatha, Palace, Jackie, Adlard, Nicholas
Format: Article
Language:English
Subjects:
Central nervous system
Distribution
Epidemiology
International aspects
Literature reviews
Meta-analysis
Multiple sclerosis
Neurological diseases
Observational studies
Prevalence
Quality control
Secondary progressive multiple sclerosis
Systematic review
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Summary:Background Secondary progressive multiple sclerosis (SPMS) is a subtype of multiple sclerosis (MS), which is a chronic neurological disease, characterised by inflammation of the central nervous system. Most of MS patients eventually progress to SPMS. This study estimates the prevalence of SPMS in the United States of America, Europe, Canada, Australia, and Brazil. Methods A systematic literature search of the Medline and Embase databases was performed using the OVID[TM] SP platform to identify MS epidemiological studies published in English from database inception to September 22, 2020. Studies reporting the prevalence of MS and proportion of SPMS patients in the included population were selected. The pooled prevalence of SPMS was calculated based on the proportion of SPMS patients. The Loney quality assessment checklist was used for quality grading. A meta-analysis of the proportions was conducted in RStudio. Results A total of 4754 articles were retrieved, and prevalence was calculated from 97 relevant studies. Overall, 86 medium- and high-quality studies were included in the meta-analysis. Most studies were conducted in European countries (84 studies). The estimated pooled prevalence of SPMS was 22.42 (99% confidence interval: 18.30, 26.95)/100,000. The prevalence of SPMS was more in the North European countries, highest in Sweden and lowest in Brazil. A decline in SPMS prevalence was observed since the availability of oral disease-modifying therapies. We also observed a regional variation of higher SPMS prevalence in urban areas compared with rural areas. Conclusion High variability was observed in the estimated SPMS prevalence, and the quality of the studies conducted. The influence of latitude and other factors known to affect overall MS prevalence did not fully explain the wide range of inter-country and intra-country variability identified in the results. Keywords: Meta-analysis, Multiple sclerosis, Prevalence, Secondary progressive multiple sclerosis
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-022-02820-0