Age and gender characteristics of patients affected with multiple sclerosis in Hungary between 2004 and 2016

Osszefoglalo. Bevezetes: Mivel hazankban a sclerosis multiplex gyakorisagarol, valamint eletkori es nemi jellegzetessegeiről az elmult evtizedekben - egeszen 2020-ig - csak regionalis jellegű felmeresek keszultek egy-egy centrum betegforgalma alapjan, az ujonnan diagnosztizalt es mar ismert betegek orszagos koreloszlasarol es annak időbeli valtozasairol nincsenek ismereteink. Celkitűzes: Jelen munkankban tobb mint 14 000 beteg adatainak elemzesevel a prevalens es incidens betegek koreloszlasanak valtozasat vizsgaljuk 2004-2016 soran, es eredmenyeinket osszevetjuk az elmult evtizedekben kozolt hazai adatokkal. Modszer: Munkacsoportunk az egeszsegbiztositasi penztar anonimizalt NEUROHUN adatbazisat elemezte, amely tartalmazza a 2004 es 2016 kozott az osszes hazai, allamilag finanszirozott, a fekvő- es jarobeteg-szakellatasbol neurologiai diagnozissal jelentett esetet. A sclerosis multiplex BNO-kodjanak előfordulasa alapjan korabban letrehoztuk a betegseg adminisztrativ definiciojat, es megbecsultuk a sclerosis multiplex orszagos prevalenciajat es incidenciajat. Eredmenyek: A prevalens betegek atlageletkora 2015-ben 47,9 ev, ugyanebben az evben az incidens betegek atlageletkora 37,4 ev volt. Vizsgalatunk szerint a prevalens betegek atlageletkora szignifikansan - evente egyotod-egyharmad evvel (p<0,001) - emelkedik, megpedig a nők eseteben nagyobb mertekben. A nők atlagosan fel evvel idősebbek, mint a ferfi paciensek (szignifikans kulonbseg: p = 0,002). A prevalens betegekben a legnepesebb korosztaly az otvenevesek felől a fiatalabb, 35-40 eves korosztaly fele mozdul. Az incidens betegek atlageletkora lassan, de szignifikansan - evente atlagosan egyharmad evvel (p<0,001) - csokken. Kovetkeztetes: Eredmenyeink szerint az ujonnan diagnosztizalt sclerosis multiplexes paciensek atlagosan egyre fiatalabbak, es a prevalens betegek kozott is egyre fiatalabb korosztalyok a legnepesebbek, de a javulo tuleles es a hosszabb elettartam miatt a prevalens betegek atlageletkora osszessegeben valoszinűleg fokozatosan emelkedik. Orv Hetil. 2021; 162(19): 746-753. SUMMARY INTRODUCTION The nationwide age and gender distribution of newly diagnosed and prevalent multiple sclerosis patients has been unknown in Hungary, as until 2020 only regional studies had been reported about the frequency and age characteristics of subjects with multiple sclerosis, based on single-center patient registries. OBJECTIVE In the present study with the analysis of over 14 000 patients, we describe the changes in age distribution of prevalent and incident subjects between 2004 and 2016 and compare our results with the data published on the subject during the last decades in Hungary. METHOD We have analyzed the pseudonymized NEUROHUN database provided by the single-payer National Health Insurance Fund, that contains each claim submitted by public hospitals and outpatient services for neurologic diseases between 2004 and 2016. Using the ICD10-code of multiple sclerosis, we have previously established the administrative definition of the illness and estimated its prevalence and incidence in the country. RESULTS The mean age of prevalent patients was 47.9 years in 2015, whereas in the same year the mean age of incident cases was 37.4 years. The average age of prevalent patients shows a significant rise - with an annual increase of one fifth-one third year (p<0.001) - with a more pronounced increase among women. The age of women is higher by half a year (p = 0.002). The most populous age groups among prevalent subjects shift from the fifties towards the younger generations between 35-40 years of age. The average age of incident subjects slowly, but significantly decreases, with a mean annual decrease of about one third year (p<0.001). CONCLUSION Our results suggest that though new patients are younger year-by-year and the most populous age groups are also younger, altogether the average age of prevalent subjects continuously increases, probably due to the longer survival and lifespan of patients with multiple sclerosis. Orv Hetil. 2021; 162(19): 746-753.