Almost every article that describes the incidence of multiple sclerosis (MS) over various epochs suggests that it is rising and that the incremental rates are higher for women than men. In recent years the claim for increasing MS incidence is particularly notable for inhabitants of the Middle East (
Almasi-Hashiani et al., 2020;
- Almasi-Hashiani A.
- Sahraian M.A.
- Eskandarieh S.
Evidence of an increased prevalence of multiple sclerosis: a population-based study of Tehran registry during 1999–2018.
BMC Neurol. 2020; 20 (Dec): 1-7
Etemadifar et al., 2020). In general, there is adjustment for population size, age and gender and sometimes for migration in or out of the relevant area. But what about other confounders? There has been significantly increased awareness of MS over the past 30 years particularly following the introduction of MRI and disease modifying treatment (DMT). Such heightened recognition may be gauged by the number of MS-related articles cited in PubMed (Fig. 1). The graph shows that the rate of MS citations has approximately doubled every 10 years. This increased awareness will filter through to clinicians, patients and their families and result in higher referral rates to secondary care centres.
- Etemadifar M.
- Nikanpour Y.
- Neshatfar A.
- Mansourian M.
- Fitzgerald S.
Incidence and prevalence of multiple sclerosis in persian gulf area: a systematic review and meta-analysis.
Mult. Scler. Relat. Disord. 2020; 40 (May 1)101959
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Christopher H Hawkes: Joint Chief Editor of Multiple Sclerosis and Related Disorders.
Gavin Giovannoni: Over the last 5 years, Professor Giovannoni has received personal compensation for participating on Advisory Boards in relation to multiple sclerosis clinical trial design, trial steering committees and data and safety monitoring committees from Abbvie, Actelion, Atara Bio, Biogen, Bristol Myers Squibb, Celgene, Genentech, Janssen, Japanese Tobacco, Merck KGAa, Novartis, Roche, Sanofi-Genzyme and Teva. Professor Giovannoni is and editor of Multiple Sclerosis and Related Disorders and chairs the MS Brain Health initiative, MS Academy and triMS.online conference. He has previously been a member of the multiple sclerosis and related disorders specialist advisory group of the Association of British Neurologists and an ECTRIMS representative. He is a director of Oxford Health Policy Forum, a non-profit social enterprise.
Jeanette Lechner-Scott: has accepted travel compensation from Novartis, Biogen, Roche and Merck. Her institution receives the honoraria for talks and advisory board commitment as well as research grants from Biogen, Merck, Roche, TEVA and Novartis.
Michael Levy: has received consulting fees from Alexion, Viela Bio and Genentech/Roche/Chugai. In addition, he has received consulting fees from Quest Diagnostics and UCB Pharmaceuticals.
Published online: September 29, 2020
© 2020 Elsevier B.V. All rights reserved.