Saturday, 13 June 2015

Males do worse than females

Ribbons KA, McElduff P, Boz C, Trojano M, Izquierdo G, Duquette P, Girard M, Grand'Maison F, Hupperts R, Grammond P, Oreja-Guevara C, Petersen T, Bergamaschi R, Giuliani G, Barnett M, van Pesch V, Amato MP, Iuliano G, Fiol M, Slee M, Verheul F, Cristiano E, Fernandez-Bolanos R, Saladino ML, Rio ME, Cabrera-Gomez J, Butzkueven H, van Munster E, Den Braber-Moerland L, La Spitaleri D, Lugaresi A, Shaygannejad V, Gray O, Deri N, Alroughani R, Lechner-Scott J. Male Sex Is Independently Associated with Faster Disability Accumulation in Relapse-Onset MS but Not in Primary Progressive MS. PLoS One. 2015;10(6):e0122686

BACKGROUND: Multiple Sclerosis is more common in women than men and females have more relapses than men. In a large international cohort we have evaluated the effect of gender on disability accumulation and disease progression to determine if male MS patients have a worse clinical outcome than females.
METHODS: Using the MSBase Registry, data from 15,826 MS patients from 25 countries was analysed. Changes in the severity of MS (EDSS) were compared between sexes using a repeated measures analysis in generalised linear mixed models. Kaplan-Meier analysis was used to test for sex difference in the time to reach EDSS milestones 3 and 6 and the secondary progressive MS.
RESULTS: In relapse onset MS patients (n = 14,453), males progressed significantly faster in their EDSS than females (0.133 vs 0.112 per year, P<0.001,). Females had a reduced risk of secondary progressive MS (HR (95% CI) = 0.77 (0.67 to 0.90) P = 0.001). In primary progressive MS (n = 1,373), there was a significant increase in EDSS over time in males and females (P<0.001) but there was no significant sex effect on the annualized rate of EDSS change.
CONCLUSION: Among registrants of MSBase, male relapse-onset patients accumulate disability faster than female patients. In contrast, the rate of disability accumulation between male and female patients with primary progressive MS is similar.
Well you can all read the results and it is telling us something that we are aware of that Males can progress a bit quicker. However it is a small difference.

Could it be lifestyle or is it just hormones. 

In the beasties, we can see the same thing that males can accumulate deficits quicker during RR-EAE than females and so sex hormones are part of the influence. Therefore for some experiments we only use males.  For others it females, as they do not fight as much.

However, again it points to different processes at the heart of progression where progression lacks the sex bias.

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