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ACTRIMS 2022 | Specific sex differences in MS prognosis

Burcu Zeydan, MD, Mayo Clinic, Rochester, MN, discusses specific sex differences in multiple sclerosis (MS) prognosis – highlighting which sex are more prone to certain phases of MS. Dr Zeydan first describes the transition from radiologically isolated syndrome (RIS) to symptomatic MS – emphasizing that being male is an important risk factor. In the relapse-remitting phase, females have been observed to recover quicker from relapses than males – with males displaying less inflammatory activity with fewer T2 hyperintense lesions, and fewer enhancing lesions, resulting in less frequent relapses, but more T1 blackholes, atrophy and slow expanding lesions. This results in greater disability during this phase. Dr Zeydan also states that once females enter the progressive phase, they accumulate disability faster than males. Whereas males have demonstrated a greater risk of entering progressive MS at an earlier stage, coinciding with the male physiological age-related decline in hormone levels. This results in a balancing of accumulative disability between sexes. This interview took place at the ACTRIMS Forum 2022 in West Palm Beach, Florida.