Incidence and prevalence of multiple sclerosis during eras of evolving diagnostic criteria—a nationwide population-based registry study over five decades

Le résumé fourni par la source

Background Impact of changing diagnostic criteria for the population-based incidence of multiple sclerosis (MS) has not been investigated. Objective To assess the effect of changing diagnostic criteria on national MS incidence and prevalence in Finland from 1974 to 2021. Methods We identified patients with MS (pwMS) through the National MS registry and the national Care Register for Healthcare and divided them into four groups based on the year of MS diagnosis: 1) Schumacher criteria (1974–1982), 2) Poser criteria (1983–2000), 3) Earlier McDonald criteria (2001–2016), and 4) Current McDonald criteria (2017–2021). Age-adjusted incidence and prevalence were calculated. Results Age-adjusted incidence per 10 5 person years increased from 3.7 (95% CI 3.5–3.8) during the Schumacher criteria period to 9.2 (95% CI 9.0–9.4) during the earlier McDonald criteria. During the Current McDonald criteria incidence stabilized to 8.6 (95% CI 8.3–9.0). Prevalence increased from 24.3 (95% CI 22.8–25.8) to 241.5 (95% CI 237.3–245.6) per 10 5 person years. Conclusion Both incidence and prevalence of MS increased significantly. Incidence showed a sharp increase when entering the twenty-first century, after which it stabilized. Increasing incidence was likely related to incorporation of MRI in the diagnostic criteria. Current diagnostic criteria did not further increase the incidence.

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