This month in Lancet
Neurology, a Canadian research team reports there is a pre-clinical phase in
MS. The study used health administration records from four Canadian provinces
(British Columbia, Saskatchewan, Manitoba, and Nova Scotia). Due to the nature
of the Canadian health-care system, these provinces have computerized
health-care records on >99% of
residents, including hospital discharges, physician billing,
prescription on records, and dates of all medical visits – all records can be
linked by a unique health-care number assigned to individuals. Using these
records, medical histories for 14,428 MS cases and 72,059 controls were
included for this study. They compared health-care utilization in the same five
years
period prior MS diagnosis between cases and temporally
matched controls.
Interestingly, five years before a MS diagnosis, the number
of hospital admissions for people who eventually developed MS was 26% higher
than controls, and this increased to 78% higher a year before MS diagnosis. A
similar pa*ern was observed for physician billing (5 years before diagnosis:
24% higher in people with MS than controls; 1 year before
diagnosis: 88%
higher in people with MS than controls). There was also a
substantial increase in the number of prescribed drug classes in people with MS
compared to controls (5 years before diagnosis: 23% higher; 1 year
before diagnosis: 49%
higher). These results clearly demonstrate a pre-clinical stage for MS where
subtle symptoms exist before clinically definitive symptoms (also known as a
prodromal stage). With further research, we can explore these subtle symptoms
and hopefully diagnose MS earlier and initiate therapeutics earlier, slowing
the rate of progression of MS.
From:
When
do MS symptoms start? By Farren Briggs PhD, ScM; The Accelerated Care Project
for Multiple Sclerosis
