MS Speaks

Presented as poster session #303   at the annual ECTRIMS conference (London, September 14-17, 2016):

Survival and mortality in multiple sclerosis: a 60-year longitudinal population study

H.M. Lunde1, J. Assmuss2, K.-M. Myhr3,4, L. Bø3,4, N. Grytten4

1Department of Clinical Medicine, KG Jebsen MS Research Centre, University of Bergen, 2Competence Centre for Clinical Research, 3Department of Neurology, Haukeland University Hospital, The Norwegian Multiple Sclerosis Centre, 4Department of Clinical Medicine, KG Jebsen MS Research Centre, University of Bergen,Norway, Bergen, Norway

Introduction:

 Mortality studies in MS have shown inconsistent results. We aimed to investigate survival, and mortality in a population based multiple sclerosis (MS) cohort.

Methods:

The study comprised all incident MS patients (N=1388) with onset during 1953-2012 in Hordaland County, Western Norway. Patient information was obtained from patient records at Haukeland University Hospital and linked to the Norwegian Causes of Death (COD) registry. Survival and patient characteristics (sex, age, disease course) were estimated by Kaplan-Meier analyses from birth and from disease onset. Mortality in MS relative to the general population was examined using standardized mortality ratio (SMR).

Results:

 Of 1388 patients, 291 had deceased, mainly of MS (56.4 %). Median survival age was 74.7 years in MS and 81.8 years in the general population (p< 0.001). Women had longer median life expectancy (77.2 years) than men (72.2 years, p=0.003) and patients with relapsing remitting MS (RRMS) survived longer ( 77.8 years) than patients with primary progressive MS (PPMS) (71.4 years, p< 0.001). Median survival from disease onset was longer in RRMS (42.8 years) than in PPMS (25.5 years, p< 0.001). Overall SMR was 2.71 ( 95 % CI: 2.4, 3.0); in RRMS 2.4 ( 95 % CI: 2.1, 2.7) and 3.9 (95 % CI: 3.1, 4.7) in PPMS. SMR from disease onset during 1953-1974 was 3.1 (95 % CI: 2.7, 3.6), during 1975-1996, 2.6 (95 % CI: 2.2, 3.1) and during 1997-2012: 0.7 (95 % CI: 0.3,1.5).

Conclusion:

The longest follow-up period of 60 years on survival and mortality in MS is here reported. MS had a 7-year lower median survival age than the general population. Risk of death was almost threefold higher in MS relative to the general population. However, an encouraging decrease in mortality was observed during the last 40 years.

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Disclosure:

Hanne Marie Bøe Lunde: nothing to disclose
Jorg Assmuss: nothing to disclose
Kjell-Morten Myhr: nothing to disclose
Lars Bø: nothing to disclose
Nina Grytten: nothing to disclose

I wish there was a way to actually establish a casual link between MS and the various illnesses & infections that cause mortality because of immunosupression or immunomodulation of the body. But these are written simply as pneumonia on the death certificate. I think mortality in MS should all have something on the death certificate thats says "died from complications from MS" plus whatever the specific cause was, unless it truly is absolutely unrelated.

More on this in MedPage Today, April 11, 2017:

https://www.medpagetoday.com/Neurology/MultipleSclerosis/64497