Three out of four cases of multiple sclerosis are diagnosed in women. If there is already a more than notable imbalance between the sexes, the trend continues, mainly due to changes in women’s lifestyles over the past half century.
“It has been observed that the incidence in men is the same as in the 50s,” he remarked. Celia Oreja-GuevaraChief of the Neurology Section at San Carlos Clinical Hospital. “On the other hand, in women, it is increased at least between 15% and 20%.”
These data come from Danish registries of disease, which are the most complete. The high incidence of multiple sclerosis in women is not uncommon among autoimmune diseases “and it appears to have nothing to do with sex hormones, although its role is not very clear.”
[Los síntomas iniciales de la esclerosis múltiple: así empieza a manifestarse la enfermedad]
The reasons for the increase in women are clear: their increased consumption of tobacco in recent decades, vitamin D deficiency (due to reduced exposure to sunlight), a more sedentary life, a worse diet…”Having a healthy life is very important for multiple sclerosis.“The doctor says.
Celia Oreja-Guevara has participated in the presentation of a new drug for the most common form of the disease, relapsing multiple sclerosis. This is Ponsimod, developed by Janssen and supported by the Optimum study, in which its efficacy was measured against one of the standard treatments for the disease, teriflunomide.
Head of Neurology Service at Val d’Hebron University Hospital in Barcelona, Javier MontalbanThose who also participated in the presentation reported that, among the results, there is a 30% reduction in the annual rate of outbreaks and a 56% reduction in the number of new active lesions detected through echocardiography.
In addition, “this is the first time that an immunomodulatory drug has shown an effect on general fatigue”, one of the so-called invisible symptoms of disease, It is easy to recognize blurred vision or poor sensitivity in the extremities, but others are invisible.
Fatigue is one of them, and is seen in 75% of patients, but there are also cognitive ones such as confusion and reduced ability to process tasks. These symptoms can affect work: only 50% of working-age MS patients do so. Only half of them work full time.
first line of treatment
Oreja-Guevara and Montalbán both agree that the new drug could be positioned as one of the initial treatment options to address multiple sclerosis and replace existing strategy.
“before We thought the most effective drugs had more side effects and were more expensive.”, indicated the neurologist. “Now we are breaking that dogma. The therapy evolved to begin with mildly effective treatments, moving toward more effective ones as the degeneration progresses, but also with more side effects.
“There are already studies showing that, if we start with a highly effective treatment from the beginning, there will be less disease progression, fewer recurrences and a better quality of life in patients with poor prognosis.”
For his part, Montalban has pointed to one exception: “The only [pacientes] The girls to whom I cannot recommend Ponsimod are girls who want to become pregnant: its use does not seem to increase the miscarriage rate, but it is more prudent to do so.”
Present in the presentation of the drug Jose Miguel LinezHead of Neurology at the University Clinical Hospital of Valencia and President of the Spanish Society of Neurology, who recalled that “neurodegenerative diseases are almost an epidemic in our society”, but that pharmaceutical research in the past 20 years has dramatically changed the radical landscape .
In this regard, Montalban states that immunology is creeping into the field, where “in this sense we have a black hole”, which will affect the understanding and management of these diseases.
The first stone in multiple sclerosis has been laid by a study published this year that relates its presence to the Epstein-Barr virus, which causes mononucleosis, a very common infection. In fact, it is speculated that some multiple sclerosis drugs are effective because they remove the virus from its reservoirs. However, Dr. Oreja-Guevara recalls that only a minority of women with the virus will develop the disease.