scholarly journals Incidence of Multiple Sclerosis and Related Disorders in Asian Populations of British Columbia

2015 ◽  
Vol 42 (4) ◽  
pp. 235-241 ◽  
Author(s):  
Joshua D. Lee ◽  
Colleen Guimond ◽  
Irene M. Yee ◽  
Carles Vilariño-Güell ◽  
Zhi-Ying Wu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
British Columbia ◽  
Neuromyelitis Optica ◽  
Temporal Trends ◽  
Asian Population ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Ethnic Population ◽  
Asian Populations ◽  
Cohort Differences

AbstractBackground: Global variation in the incidence of multiple sclerosis (MS) is generally ascribed to differences in genetic and environmental risk factors. Here we investigate temporal trends in the incidence of MS and related disorders in British Columbia, Canada, from 1986 to 2010, focusing particularly on the Asian ethnic subpopulation. Methods: A longitudinal database was screened to identify newly diagnosed cases of MS and related disorders, including neuromyelitis optica and clinically isolated syndromes. Age-standardized, sex-specific mean annual incidence was calculated for the Asian and non-Asian population of British Columbia for 5-year intervals from 1986 to 2010. Temporal changes and cohort differences in incidence rates and demographic characteristics were evaluated. Results: During this period, the incidence of MS and related disorders in the non-Asian population remained relatively unchanged, from 10.41 (95% confidence interval [CI]: 9.87-10.97) to 9.91 (95% CI: 9.46-10.39) per 100,000 (p=0.167). In contrast, incidence in the Asian population doubled during the same period. This increase was driven by a precipitous rise in the incidence of MS in females from 0.71 (95% CI: 0.01-1.50) to 2.08 (95% CI: 1.43-2.91) per 100,000 (p=0.004), including both Canadian-born and immigrant Asians. The incidence of neuromyelitis optica did not change significantly during this period. Conclusions: The incidence of MS may be increasing among females in the Asian ethnic population of British Columbia.

scholarly journals Evaluating the safety of β-interferons in MS

Neurology ◽  
2017 ◽  
Vol 88 (24) ◽  
pp. 2310-2320 ◽  
Author(s):  
Hilda J.I. de Jong ◽  
Elaine Kingwell ◽  
Afsaneh Shirani ◽  
Jan Willem Cohen Tervaert ◽  
Raymond Hupperts ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
British Columbia ◽  
Adverse Event ◽  
Adverse Events ◽  
Conditional Logistic Regression ◽  
Fold Increase ◽  
Incidence Rates ◽  
Incidence Density ◽  
Cohort Entry ◽  
Potential Adverse Event

Objective:To examine the association between interferon-β (IFN-β) and potential adverse events using population-based health administrative data in British Columbia, Canada.Methods:Patients with relapsing-remitting multiple sclerosis (RRMS) who were registered at a British Columbia Multiple Sclerosis Clinic (1995–2004) were eligible for inclusion and were followed up until death, absence from British Columbia, exposure to a non–IFN-β disease-modifying drug, or December 31, 2008. Incidence rates were estimated for each potential adverse event (selected a priori and defined with ICD-9/10 diagnosis codes from physician and hospital claims). A nested case-control study was conducted to assess the odds of previous IFN-β exposure for each potential adverse event with at least 30 cases. Cases were matched by age (±5 years), sex, and year of cohort entry, with up to 20 randomly selected (by incidence density sampling) controls. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated with conditional logistic regression adjusted for age at cohort entry.Results:Of the 2,485 eligible patients, 77.9% were women, and 1,031 were treated with IFN-β during follow-up. From the incidence analyses, 27 of the 47 potential adverse events had at least 30 cases. Patients with incident stroke (ORadj 1.83, 95% CI 1.16–2.89), migraine (ORadj 1.55, 95% CI 1.18–2.04), depression (ORadj 1.33, 95% CI 1.13–1.56), and hematologic abnormalities (ORadj 1.32, 95% CI 1.01–1.72) were more likely to have previous exposure to IFN-β than controls.Conclusions:Among patients with RRMS, IFN-β was associated with a 1.8- and 1.6-fold increase in the risk of stroke and migraine and 1.3-fold increases in depression and hematologic abnormalities.

Temporal trends in multiple sclerosis prevalence and incidence in a large population

Neurology ◽  
2018 ◽  
Vol 90 (16) ◽  
pp. e1435-e1441 ◽  
Author(s):  
Dalia L. Rotstein ◽  
Hong Chen ◽  
Andrew S. Wilton ◽  
Jeffrey C. Kwong ◽  
Ruth Ann Marrie ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sex Ratio ◽  
Media Coverage ◽  
Latitudinal Gradient ◽  
Large Population ◽  
Temporal Trends ◽  
Delayed Diagnosis ◽  
Population Based ◽  
Incidence Rates ◽  
Health Administrative Data

ObjectiveWe sought to better understand the reasons for increasing prevalence of multiple sclerosis (MS) by studying prevalence in relation to incidence, mortality rates, sex ratio, and geographic distribution of cases.MethodsWe identified MS cases from 1996 to 2013 in Ontario, Canada, by applying a validated algorithm to health administrative data. We calculated age- and sex-standardized prevalence and incidence rates for the province and by census division. Incidence and prevalence sex ratios for women to men were computed.ResultsThe prevalence of MS increased by 69% from 1.57 (95% confidence interval [CI]: 1.54–1.59) per 1,000 in 1996 (n = 12,155) to 2.65 (95% CI: 2.62–2.68) in 2013 (n = 28,192). Incidence remained relatively stable except for a spike in 2010, followed by a subsequent decline in 2011–2013, particularly among young people and men. Mortality decreased by 33% from 26.7 (95% CI: 23.5–30.3) per 1,000 to 18.0 (95% CI: 16.4–19.8) per 1,000. The incidence sex ratio was stable from 1996 to 2009, then declined in 2010, with partial rebound by 2013. MS prevalence and incidence showed no consistent association with latitude.ConclusionIn this large, population-based MS cohort, we found stable incidence and increasing prevalence of MS; the latter largely reflected declining mortality. A spike in incidence in 2010 among younger patients and men at a time of widespread media coverage of MS suggests that these groups may be vulnerable to delayed diagnosis. We did not find a latitudinal gradient; however, most Ontarians live between the 42nd and 46th parallels, reducing our ability to detect an effect of latitude.

Temporal trends of disability progression in multiple sclerosis: findings from British Columbia, Canada (1975–2009)

2011 ◽  
Vol 18 (4) ◽  
pp. 442-450 ◽  
Author(s):  
Afsaneh Shirani ◽  
Yinshan Zhao ◽  
Elaine Kingwell ◽  
Peter Rieckmann ◽  
Helen Tremlett
Keyword(s):  
Multiple Sclerosis ◽  
British Columbia ◽  
Natural History ◽  
Disease Progression ◽  
Methodological Approach ◽  
Age At Onset ◽  
Temporal Trends ◽  
Primary Analysis ◽  
Time Period ◽  
Natural History Studies

Background: Recent natural history studies suggest that multiple sclerosis (MS) is a more slowly progressing disease than previously thought. These observations are from studies separated by time, geography and methodological approach. Objectives: We investigated whether MS disease progression has changed over time in British Columbia, Canada. Methods: The British Columbia MS database was queried for relapsing-onset MS patients with symptom onset from 1975 to <1995, first assessed within 15 years from onset and with at least two Expanded Disability Status Scale (EDSS) scores. Latest follow-up was to 2009. Patients were grouped by 5-year onset intervals (1975 to <1980, 1980 to <1985, 1985 to <1990, 1990 to <1995). Outcome was defined as time to reach sustained and confirmed EDSS 6 within 15 years of disease duration. Kaplan–Meier analysis was used to compare: the proportion of patients reaching EDSS 6 (primary analysis) and the time to EDSS 6 (secondary analysis) across the time-period groups. Results: A total of 2236 relapsing-onset MS patients (73.4% female; mean age at onset: 32.3 ± 8.8 years) were included. No significant temporal trend was found in the proportion of patients reaching EDSS 6 within 15 years from onset (28.5%, 26.4%, 27.7%, 22.3% for intervals 1975 to <1980, 1980 to <1985, 1985 to <1990, 1990 to <1995, respectively; p = 0.09) or in survival curves for time to reach the outcome ( p = 0.14). Conclusions: Rates of disease progression remained relatively stable over two decades of MS onset in British Columbia, Canada. Our results suggest that differences in disease progression findings between natural history studies may be related to factors other than time period.

Infections in hospitalized lupus nephritis patients: characteristics, risk factors, and outcomes

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1150-1158 ◽  
Author(s):  
P Liu ◽  
H Z Tan ◽  
H Li ◽  
C C Lim ◽  
J C J Choo
Keyword(s):  
Lupus Nephritis ◽  
Mixed Models ◽  
Asian Population ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Infection Rates ◽  
Risk Characteristics ◽  
Chinese Ethnicity ◽  
End Stage

Background There are limited studies documenting infection epidemiology in lupus nephritis (LN) patients. We aimed to study infection incidences and risk characteristics and ascertain possible predictors of infective outcomes in a multiethnic Asian population. Methods This retrospective study from 2006 to 2012 included newly diagnosed LN patients. We collected admissions, immunosuppression, and infection data until end-stage renal failure, death, last follow-up, or the year 2015. The infection incidence rates were evaluated and a generalized linear latent and mixed models (GLLAMM) analysis was carried out to evaluate potential predictors of infection. Results Our cohort of 101 patients consisted of mainly Chinese (75.2%), females (78.2%), and a median age of 38 years (IQR 26–49). The median time of follow-up was 72.8 months (IQR 49.5–94.0). Six out of 14 patient deaths were infection related. Seventy-eight out of 200 admissions, with a total of 102 episodes of infection, occurred in 46 patients. The incidence of infection rates leading to admissions was 10.3 per 100 person-years and the incidence of infection episodes rates was 17.6 per 100 person-years. Cytomegalovirus (CMV) was the most common organism identified. Univariate GLLAMM analysis showed Malay compared to Chinese ethnicity (HR 2.833 (95% CI 1.088–7.373)), use of oral cyclophosphamide (HR 6.618 (95% CI 1.015–43.154)) and rituximab (HR 3.967 (95% CI 1.157–13.603)) as predictors of infection-related admissions. Malay ethnicity and rituximab remained significant in the multivariate GLLAMM analysis. Conclusions Our study highlights substantial infection incidences in patients with LN and its contribution to deaths.

Gene Polymorphisms and Their Association to Coronavirus Family Infections: Susceptibility in Different Populations

2020 ◽  
Vol 5 ◽  
Keyword(s):  
Genetic Variants ◽  
Viral Infections ◽  
Human Leukocyte ◽  
Asian Population ◽  
African Region ◽  
Mediterranean Populations ◽  
Susceptibility To Infection ◽  
Asian Populations ◽  
Spread Pattern ◽  
Different Populations

Human leukocyte antigen (HLA) loci are highly polymorphic and determine differential features of the immune response in subjects from different regions. HLA genes have been proposed to determine genetic susceptibility to several diseases, particularly to viral infections. Moreover, it has been suggested that each ethnic group could have a different specificity of T-lymphocyte reactivity to the same viral infections. In this review, we analyzed the distribution of HLA types in countries of the Asian, European and North African region. Also, we studied the relation between these HLA polymorphisms and susceptibility to infection by the coronavirus. Our findings indicated that homozygosity would increase susceptibility to viral infections and, in some cases, to coronavirus infection. HLA types showing higher susceptibility were reported in Asian population, including China, Singapore, and Taiwan. In contrast, lower susceptibility HLA variants were detected among African populations, some Asian populations, and Mediterranean populations. The presented evidence along with the spread pattern of COVID-19 infection suggests that HLA genetic variants might be related to its infection susceptibility and severity. The investigation of HLA genetic variants distribution would be a useful tool to predict different populations’ susceptibility to viral infections.

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