Abstract
Objective: To identify and highlight differences in Secondary Progressive Multiple Sclerosis (SPMS) prevalence in three European multiple sclerosis (MS) registries.
Background: There is significant uncertainty and a lack of scientific information to enable characterisation of the prevalence and course of SPMS in different populations. We therefore sought to use real world data from three clinical MS registries in Europe to enhance current understanding.
Design/Methods: Data from MS registries in Germany, United Kingdom (UK) and Sweden were used. Inclusion criteria were patients with relapsing remitting MS (RRMS) or SPMS, age ≥ 18 years at the beginning of the study period (01/2016–10/2019). We included 21,552 German patients, 3,486 UK patients and 11,907 Swedish patients. The SPMS proportion was calculated at the end of the study period and only patients with at least one Expanded Disability Status Scale (EDSS) score during the study period were included. An SPMS decision tree classifier (Ramanujam, et al., 2016. P897, ECTRIMS), previously trained on Swedish data with age and EDSS as input variables, was used. The predicted phenotype from the classifier was compared with clinically assigned MS courses (RRMS vs SPMS).
Results: The clinically assigned SPMS proportion was 16.6% for Germany, 13.8% in the UK and 24.5% in Sweden. After applying the decision tree classifier to the patients’ latest EDSS score and age, the SPMS proportion increased to 26.2% in Germany, 35.6% in UK and 25.4% in Sweden.
Conclusions: There were striking differences in the proportion of clinically assigned SPMS between the three registries. By applying a classifier that allowed for reclassification of RRMS/SPMS patients, the SPMS proportions increased dramatically in the validation datasets and became more comparable. Our findings suggest that the size of the SPMS population may be substantially underestimated when clinically assigned courses are used. Further research is required to elaborate on these findings.
Disclosure: Dr. Forsberg has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Cubist IT AB. Dr. Forsberg holds stock and/or stock options in AstraZeneca. Dr. Stahmann has received research support from Biogen, Celgene, Merck and Novartis.Dr. Middleton has nothing to disclose. Dr. Ellenberger has nothing to disclose. Dr. Rodgers has nothing to disclose. Dr. Nicholas has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen, Roche, Novartis. Dr. Nicholas has received research support from Biogen, Novartis and Roche. Dr. Ramanujam has nothing to disclose. Dr. Manouchehrinia has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen. Dr. Pillai has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with IQVIA. Dr. Pillai holds stock and/or stock options in Novartis. Dr. Dobay has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with IQVIA. Dr. Lines has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis. Dr. Hach has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis Pharma AG.Dr. Glaser has nothing to disclose. Dr. Hillert has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Merck, Biogen, Novartis, Sandoz, Celgene, and Sanofi. Dr. Hillert has received research support from Biogen, Novartis, Merck, and Roche.
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