Study Suggests Possible Prodrome for Multiple Sclerosis

A prodromal period for multiple sclerosis (MS) may exist 5 years before any clinical manifestations, according to the findings of a new study. 

For their study, the researchers used data from linked health administrative and clinical databases from 4 Canadian provinces to compare hospital physician, and prescription use data from 14,428 individuals with MS and 72,059 matched controls in the 5 years before the first clinically reported symptom onset or demyelinating disease claim.
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When compared with the matched controls, annual health care use by people with MS increased steadily between 5 years and 1 year before the first demyelinating disease claim. A similar pattern was observed for physician claims and prescriptions among individuals with MS with available clinical symptom onset.

However, differences in health care use in each of the 5 years mostly did not reach statistical significance. 

“More frequent use of health care in patients with multiple sclerosis than in controls in the 5 years before a first demyelinating event, according to health administrative data, suggests the existence of a measurable multiple sclerosis prodrome,” the researchers concluded. “These findings have clinical and research implications, including the establishment of an earlier window of opportunity to identify and potentially treat multiple sclerosis.”

—Melissa Weiss

Reference:

Wijnands JMA, Kingwell E, Zhu F, et al. Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study [published online April 20, 2017]. Lancet Neurol. dx.doi.org/10.1016/S1474-4422(17)30076-5.