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Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study

BACKGROUND: Persons with multiple sclerosis (pwMS) have higher risk of mortality compared with the general population. Longitudinal studies are important for understanding the evolution of survival in pwMS. OBJECTIVE: Examine changes in mortality among pwMS during the past seven decades. METHODS: We...

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Autores principales: Willumsen, Johannes Sverre, Grytten, Nina, Aarseth, Jan, Myklebust, Tor Åge, Myhr, Kjell-Morten, Midgard, Rune
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9606487/
https://www.ncbi.nlm.nih.gov/pubmed/36096665
http://dx.doi.org/10.1136/jnnp-2022-329169
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author Willumsen, Johannes Sverre
Grytten, Nina
Aarseth, Jan
Myklebust, Tor Åge
Myhr, Kjell-Morten
Midgard, Rune
author_facet Willumsen, Johannes Sverre
Grytten, Nina
Aarseth, Jan
Myklebust, Tor Åge
Myhr, Kjell-Morten
Midgard, Rune
author_sort Willumsen, Johannes Sverre
collection PubMed
description BACKGROUND: Persons with multiple sclerosis (pwMS) have higher risk of mortality compared with the general population. Longitudinal studies are important for understanding the evolution of survival in pwMS. OBJECTIVE: Examine changes in mortality among pwMS during the past seven decades. METHODS: We followed pwMS from Hordaland and Møre and Romsdal in Western Norway, with disease onset from before 1950, identified from population-based epidemiological surveys and the Norwegian MS Registry and Biobank, until 1 January 2021. Data were linked to the Norwegian Cause of Death Registry to obtain underlying cause of death. We examined all-cause, and cause-specific mortality using standardised mortality ratios (SMR) and excess death rates (EDR). We calculated life expectancies and assessed survival stratified by sex, age and disease phenotype at onset. We compared hazard ratios (HRs) for mortality, in pwMS diagnosed before and after the era of disease-modifying treatment (DMT). RESULTS: Of 3624 pwMS, 964 (55.5% women) had died, predominantly of multiple sclerosis (49.0%). Median life expectancy for pwMS was 74.3 years (95% CI 73.3 to 75.3), compared with 83.1 years for the general population (p<0.001). From disease onset, pwMS survived 14.6 years shorter than the general population (p<0.001). Overall, SMR was 2.3 (95% CI 2.13 to 2.42) and EDR was 6.8 (95% CI 6.42 to 7.09) for pwMS. Treatment-eligible pwMS diagnosed in the DMT era had the lowest risk of mortality, HR 0.49 (95% CI 0.34 to 0.70, p<0.001). CONCLUSION: Excess mortality among pwMS declined during the past seven decades, possibly due to improved diagnostics, better symptomatic treatment and access to DMTs.
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spelling pubmed-96064872022-10-28 Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study Willumsen, Johannes Sverre Grytten, Nina Aarseth, Jan Myklebust, Tor Åge Myhr, Kjell-Morten Midgard, Rune J Neurol Neurosurg Psychiatry Multiple Sclerosis BACKGROUND: Persons with multiple sclerosis (pwMS) have higher risk of mortality compared with the general population. Longitudinal studies are important for understanding the evolution of survival in pwMS. OBJECTIVE: Examine changes in mortality among pwMS during the past seven decades. METHODS: We followed pwMS from Hordaland and Møre and Romsdal in Western Norway, with disease onset from before 1950, identified from population-based epidemiological surveys and the Norwegian MS Registry and Biobank, until 1 January 2021. Data were linked to the Norwegian Cause of Death Registry to obtain underlying cause of death. We examined all-cause, and cause-specific mortality using standardised mortality ratios (SMR) and excess death rates (EDR). We calculated life expectancies and assessed survival stratified by sex, age and disease phenotype at onset. We compared hazard ratios (HRs) for mortality, in pwMS diagnosed before and after the era of disease-modifying treatment (DMT). RESULTS: Of 3624 pwMS, 964 (55.5% women) had died, predominantly of multiple sclerosis (49.0%). Median life expectancy for pwMS was 74.3 years (95% CI 73.3 to 75.3), compared with 83.1 years for the general population (p<0.001). From disease onset, pwMS survived 14.6 years shorter than the general population (p<0.001). Overall, SMR was 2.3 (95% CI 2.13 to 2.42) and EDR was 6.8 (95% CI 6.42 to 7.09) for pwMS. Treatment-eligible pwMS diagnosed in the DMT era had the lowest risk of mortality, HR 0.49 (95% CI 0.34 to 0.70, p<0.001). CONCLUSION: Excess mortality among pwMS declined during the past seven decades, possibly due to improved diagnostics, better symptomatic treatment and access to DMTs. BMJ Publishing Group 2022-11 2022-09-12 /pmc/articles/PMC9606487/ /pubmed/36096665 http://dx.doi.org/10.1136/jnnp-2022-329169 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Multiple Sclerosis
Willumsen, Johannes Sverre
Grytten, Nina
Aarseth, Jan
Myklebust, Tor Åge
Myhr, Kjell-Morten
Midgard, Rune
Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title_full Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title_fullStr Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title_full_unstemmed Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title_short Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study
title_sort mortality and cause of death in multiple sclerosis in western norway 1950–2021: a registry-based linkage study
topic Multiple Sclerosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9606487/
https://www.ncbi.nlm.nih.gov/pubmed/36096665
http://dx.doi.org/10.1136/jnnp-2022-329169
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