Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
Sex-specific analysis of early disease course and treatment in a German multiple sclerosis cohort.
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Poser Philip Lennart, Gisevius Barbara, Tokic Marianne, Fisse Anne Lena, Ladopoulos Theodoros, Berthele Achim, Giglhuber Katrin, Flaskamp Martina, Fleischer Vinzenz, Bittner Stefan, Lüssi Felix, Bayas Antonios, Meuth Sven G, Heesen Christoph, Trebst Corinna, Wildemann Brigitte, Then Bergh Florian, Antony Gisela, Kümpfel Tania, Havla Joachim, Paul Friedemann, Nischwitz Sandra, Tumani Hayrettin, Zettl Uwe, Hemmer Bernhard, Wiendl Heinz, Zipp Frauke, Timmesfeld Nina, Gold Ralf, Motte Jeremias, Salmen Anke
Аннотация
BACKGROUND: Understanding sex differences in relapsing-remitting multiple sclerosis (RRMS) and initiation of disease-modifying treatments (DMTs) is crucial for tailored approaches.
OBJECTIVE: The objective of this study is to analyze sex-specific differences in early RRMS.
METHODS: We analyzed data of therapy-naïve adults from the German NationMS cohort to describe first symptoms, onset relapse treatment, disability evolution, and DMT exposure separated by sex to investigate previously described sex differences.
RESULTS: Relapse presentation and treatment were similar (p = n.s.). Time to Expanded Disability Status Scale (EDSS) ⩾3.0 was comparable between sexes (adjusted hazard ratio, 95% confidence interval (95% CI): 1.32 (0.95-1.81)). DMT exposure did not differ (p = 0.60). Around 5.0% of both sexes received initial high-efficacy (HE) DMT. Younger age (odds ratio (OR) (95% CI): 0.95 (0.92-0.98); p = 0.000847), higher baseline EDSS (1.79 (1.40-2.27); p = 0.00000218), and RRMS diagnosis (2.26 (1.28-4.17), p = 0.006703) were associated with initial HE-DMT, but not sex (0.99 (0.57-1.77), p = 0.943166).
CONCLUSION: We did not observe major sex differences in early MS as described earlier regarding initial presentation and disability evolution suggesting a change of MS course. The decision for initial HE-DMT was influenced by younger age and higher EDSS, but not sex suggesting a lower sex bias regarding the initial treatment decision, yet only investigated in specialized academic MS centers.
OBJECTIVE: The objective of this study is to analyze sex-specific differences in early RRMS.
METHODS: We analyzed data of therapy-naïve adults from the German NationMS cohort to describe first symptoms, onset relapse treatment, disability evolution, and DMT exposure separated by sex to investigate previously described sex differences.
RESULTS: Relapse presentation and treatment were similar (p = n.s.). Time to Expanded Disability Status Scale (EDSS) ⩾3.0 was comparable between sexes (adjusted hazard ratio, 95% confidence interval (95% CI): 1.32 (0.95-1.81)). DMT exposure did not differ (p = 0.60). Around 5.0% of both sexes received initial high-efficacy (HE) DMT. Younger age (odds ratio (OR) (95% CI): 0.95 (0.92-0.98); p = 0.000847), higher baseline EDSS (1.79 (1.40-2.27); p = 0.00000218), and RRMS diagnosis (2.26 (1.28-4.17), p = 0.006703) were associated with initial HE-DMT, but not sex (0.99 (0.57-1.77), p = 0.943166).
CONCLUSION: We did not observe major sex differences in early MS as described earlier regarding initial presentation and disability evolution suggesting a change of MS course. The decision for initial HE-DMT was influenced by younger age and higher EDSS, but not sex suggesting a lower sex bias regarding the initial treatment decision, yet only investigated in specialized academic MS centers.