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AAN 2022 | Sex differences in multiple sclerosis disease course over 25 years of follow up

Melinda Magyari, MD, PhD, The Danish Multiple Sclerosis Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, talks about the gender differences in multiple sclerosis (MS). Dr Magyari outlines the findings of a nationwide cohort study with over 25 years of follow up, looking at differences in onset symptoms, relapses, and disability development between men and women in the Danish MS Registry. There was a slight, expected difference in baseline characteristics, including a younger age of onset and slightly higher relapse rate in females. It was also observed that the frequency of breakthrough relapses was higher in women compared to men, until around the age of menopause, implicating sex hormones as a factor underlying the higher inflammatory disease activity in women. The study also measured how quickly Expanded Disability Status Scale (EDSS) milestones were reached by the two cohorts, determining that males had more progression, based on a higher mean increase in EDSS per year. Overall, the study quantified sex differences in the inflammatory and neurodegenerative component of MS. Accordingly, Dr Magyari recommends that a step forward in personalized MS care would be for clinicians to consider gender and age first and further investigate the interplay between sex hormones and MS. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.