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?

• Published in: Multiple sclerosis and related disorders 2022-02, Vol.58, p.103401-103401, Article 103401
• Main Authors: Luetic, Geraldine G., Menichini, María Laura, Vrech, Carlos, Pappolla, Agustín, Patrucco, Liliana, Cristiano, Edgardo, Marrodán, Mariano, Ysrraelit, María C., Fiol, Marcela, Correale, Jorge, Cohen, Leila, Alonso, Ricardo, Silva, Berenice, Casas, Magdalena, Garcea, Orlando, Deri, Norma, Burgos, Marcos, Liwacki, Susana, Tkachuk, Verónica, Barboza, Andrés, Piedrabuena, Raúl, Blaya, Patricio, Steinberg, Judith, Martínez, Alejandra, Carrá, Adriana, Tavolini, Darío, López, Pablo, Knorre, Eduardo, Nofal, Pedro, Volman, Gabriel, Carnero Contentti, Edgar, Pinheiro, Amelia Alves, Leguizamon, Felisa, Silva, Emanuel, Hryb, Javier, Balbuena, María Eugenia, Zanga, Gisela, Kohler, Matías, Chertcoff, Aníbal, Lazaro, Luciana, Tizio, Santiago, Mainela, Carolina, Reich, Edgardo, Recchia, Luciano, Blanche, Jorge, Marcilla, Marcela Parada, Fracaro, María Eugenia, Sgrilli, Gustavo, Divi, Pablo, Jacobo, Miguel, Cabrera, Mariela, Pagani Cassara, Fátima, Sinay, Vladimiro, Curbelo, Celeste, Míguez, Jimena, Coppola, Mariano, Liguori, Nora Fernández, Martos, Iván, Pettinicchi, Juan Pablo, Viglione, Juan Pablo, José, Gustavo, Bestoso, Santiago, Manzi, Rubén, Vázquez, Guido, Nadur, Débora, Martínez, Carlos, Serena, Marina Alonso, Rojas, Juan I.
• Format: Article
• Language: English
• Subjects: Argentina; Demography; Disease Progression; Female; Humans; Male; MS biological sex; MS clinical and demographic characteristics; MS in men; MS phenotype; Multiple Sclerosis - diagnosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis, Relapsing-Remitting - epidemiology; Phenotype; Prognosis; Registries; Retrospective Studies
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2021.103401

•Data in cohort MS studies is seldom disaggregated by sex and males are poorly considered.•Results in MS studies may be markedly biased by the female predominance of the disease.•Men present as double the frequency of PPMS than women.•Clinical and demographic data differ between men and women mostly due to the disease course than to sex.•It's crucial to include stratified analysis by sex and phenotype when designing MS studies. 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. 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. 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. 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). 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.