Emerging trends and challenges in multiple sclerosis in Europe: rethinking classification and addressing COVID-19 impact
Year: 2024
Type: article
Abstract: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system.It is one of the most common causes of neurological disability in the young adult population.Worldwide about 2.8 million people are affected, with an increasing incidence and prevalence over the last decades.1 Progress in MS care has occurred on multiple levels, but particularly includes earlier diagnosis and higher efficacy of therapies, improving the likelihood of disease control and also long-term prognosis.2 Furthermore, although the COVID-19 pandemic challenged MS care, the lessons and advances made at that time are now being used to improve patient care.Two papers published in The Lancet regional Health-Europe for the Series on Multiple Sclerosis 2024 outline the emerging epidemiological trends in Europe while stressing the limits of traditional classification of MS course 3 and highlight the impact of COVID-19 pandemic on MS care in Europe.4 Portaccio et al. 3 discuss current trends in incidence and prevalence in Europe.In this article they identify certain factors that have contributed to shifting the peak prevalence to the sixth decade of lifemodifying the risk of comorbidities and side effectssuch as improved prognosis and reduced disease-related mortality, different diagnostic criteria and demographic changes.In Europe, there is a latitudinal gradient of MS with a high-risk region in the northern part, which probably underlines the predominant role of distinct environmental factors.Besides differences in incidence, differences in the availability of disease-modifying therapies (DMTs) and rehabilitation in Europe remain a challenge in a chronic disease with a high socioeconomic burden.Furthermore, this article challenges the traditional view of the clinical course of MS, as a separation between relapsing-remitting (RR), secondary progressive (SP) and primary progressive (PP) disease course.This concept did not always reflect the clinical reality with indistinct boundaries, especially between RR and SPMS (see Fig. 1).Thus, there is a clear need for a more uniform and data driven view that considers more than two dimensions (relapses and progression) in MS.
Authors: Catharina Korsukewitz, Heinz Wiendl
Institutions: University of Münster, University Hospital Münster
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,000
OpenAlex ID: W4401804282