From the Guidelines
Multiple sclerosis (MS) affects approximately 3-7 per 100,000 males aged 25-35 annually, with males in this age group having about half the incidence rate compared to females of the same age. MS typically presents in young adults, with peak onset between ages 20-40, making this 25-35 age range a critical period for diagnosis 1. Males in this demographic tend to experience more severe disease progression when diagnosed, often presenting with more motor symptoms and less sensory manifestations than females. The male-to-female ratio for MS is approximately 1:3, reflecting a significant gender disparity in disease prevalence. Environmental factors (vitamin D deficiency, smoking), genetic predisposition, and possibly hormonal differences contribute to MS development in this population. Early symptoms in young men often include vision problems, fatigue, numbness, and coordination difficulties.
Key Considerations for Diagnosis
- The clinical syndrome should be typical of demyelination, with the criteria applied to adult patients between 18 and 50 years 1.
- MRI studies should be of adequate quality, with few artefacts and performed on scanners with a minimum field strength of 1.5 T.
- Key MRI sequences include T2-weighted and T1 post-gadolinium images of the brain and the spinal cord.
Importance of Prompt Diagnosis
Prompt diagnosis through MRI, spinal fluid analysis, and clinical evaluation is essential, as early treatment with disease-modifying therapies can significantly improve long-term outcomes for males in this age group. Early treatment is crucial to reduce morbidity, mortality, and improve quality of life in males with MS. The diagnosis of MS should be made by trained clinicians or (neuro)radiologists deeply familiar with the features of MS and disorders considered in the differential diagnosis 1.
From the Research
MS Rates Among Males 25-35
- The incidence of multiple sclerosis (MS) in males has remained relatively unchanged over the years, whereas the incidence in females has increased significantly 2.
- A study found that the risk of developing MS in women has more than doubled in 25 years, while it has remained virtually unchanged for men 2.
- The explanation for these epidemiological changes is thought to be related to environmental factors, as genetics only explain a small part of the MS risk 2.
- There is no specific data available on MS rates among males aged 25-35, but it is known that MS can affect anyone at any age, and the risk of developing MS is higher in women than in men 3.
- A study found that males who develop MS may exhibit a more rapid decline in disability and cognitive functioning than women, but the biological basis of this difference is not well understood 3.
Factors Influencing MS Risk
- Pregnancy may have a biological protective effect against developing MS in women, lasting for about five years 2.
- The trend towards fewer childbirths in the female population over decades may contribute to the increasing sex ratio and female incidence of MS 2.
- Socio-economic status and lifestyle expressed in educational level and the sanitary conditions in youth are not associated with the risk of MS 2.
- Working in agriculture may be associated with a higher MS risk in women, but this finding is based on small numbers and requires further investigation 2.
Treatment and Management of MS
- Interferons-beta (IFNs-beta) and glatiramer acetate (GA) are two disease-modifying therapies (DMTs) commonly used to treat MS 4, 5.
- A systematic review found that IFNs-beta and GA have similar clinical efficacy in reducing relapse rates and slowing disease progression in patients with relapsing-remitting MS 4.
- Another study found that GA can be an effective treatment option for patients who have previously received IFN-beta-1b therapy 5.
- A cost-effectiveness analysis found that DMTs are clinically effective for relapsing-remitting MS and clinically isolated syndrome, but are only cost-effective for clinically isolated syndrome 6.