Search

In France, few data sources are available to estimate the impact of multiple sclerosis (MS) on job retention and its consequences on the level of resources, especially in large representative samples. The aim of the present study was to measure impact of MS on employment rates, wages and income (including unemployment benefit, sickness benefit and disability pension) by comparing work trajectories of people living with MS with those of a matched control group. We used the HYGIE database, which is the result of the linkage of two administrative databases in the private sector for a random sample of over 900,000 people. In order to identify the causal effect of MS on employment after 1 to 20 years, the difference-in-differences method with matching (age, sex, career and health history) was used, overall and in subgroups. The year of entry in long-term disease status for MS was used to approximate the onset of MS. Overall, 946 people with MS were included. Their situation was fairly favorable before MS (88.1% in employment, resources higher than the median for the general population), but MS had strong and continuous negative effects. Indeed, at 10 years, the employment rate fell by 28.6 percentage points (pp) and the disability pension allowance increased by 50.5 pp; the wage percentile fell by 19.2 pp and the replacement income accounted for a growing share of total income (+ 39.7 pp). Although administrative data had several strengths, clinical information on the severity of the disease or on its therapeutic management was not available. In conclusion, this study shows that the effects of MS on the employed population in the private sector occur early in the disease course and are cumulative, and that replacement income helps to reduce the loss of resources thanks to the French health and social system.

France is among the countries with high prevalence of multiple sclerosis (MS). The most recent estimates are from 2012 and need to be updated because MS prevalence has increased worldwide.

Six monthly courses of mitoxantrone were approved in France in 2003 for patients with highly active multiple sclerosis (MS).

Les facteurs de risque de mortalité modifiables sont peu étudiés dans la sclérose en plaques (SEP). La défavorisation socioéconomique et une mauvaise accessibilité aux soins sont deux facteurs de risque avérés dans d'autres pathologies. L'objectif était d'examiner l'influence de la défavorisation socioéconomique ainsi que de l'accessibilité aux soins primaires et neurologiques spécialisés sur la mortalité en excès dans la SEP.

Les patients avec sclérose en plaques (SEP) ont eu un accès prioritaire à la vaccination contre le SARS-CoV-2. De nombreux cas de poussées subséquents à la vaccination ont été reportés dans la littérature, décourageant les patients à recevoir la dose de rappel, dans cette population parfois déjà réticente. L'objectif de cette étude était d’évaluer le risque de poussée suivant la vaccination contre le COVID-19 dans la population de patients avec SEP en France.

Establish recommendations for the management of UTIs in MS patients.

La littérature scientifique sur le risque de cancer chez les personnes atteintes de la sclérose en plaques (pSEP) diverge. Actuellement, la société francophone de la sclérose en plaques recommande que les pSEP suivent les pratiques de dépistage de la population générale.

Les pratiques de dépistage du cancer des personnes atteintes de la sclérose en plaques (pSEP) en France ne sont pas documentées. Actuellement, la société francophone de la sclérose en plaques préconise de suivre les recommandations de la population générale.

To establish recommendations on immunization for patients with multiple sclerosis (MS).

Given the health, social and economic burden of neurodegenerative diseases (ND), the development of epidemiologic studies is required. Administrative databases, such as the French national health insurance database (SNIIRAM) could represent an opportunity for researchers. ND could be presumed from drug reimbursement data, hospital stays or registration of a chronic condition. The aim of this study was to describe, in French administrative databases, algorithms used to identify Alzheimer's disease and associated disorders (ADAD), Parkinson's disease and associated disorders (PDAD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS).

La sclerosi multipla (SM) è una malattia neurologica dei giovani adulti (età media all’esordio intorno ai 30 anni) di cui due terzi dei casi è costituito da donne. Gli studi di prevalenza rivelano grandi disuguaglianze nel mondo, con la più alta frequenza in Nord America e in Europa (> 100 per 100 000 abitanti) e la più bassa in Asia e in Africa (2 per 100 000). In totale, attualmente si contano 2,8 milioni di casi nel mondo, di cui circa 120 000 in Francia. Questi numeri aumentano con ogni nuovo studio, probabilmente riflettendo un migliore conteggio dei casi, ma questo aumento è anche possibilmente legato a un aumento dell’incidenza e a un aumento della durata della vita dei pazienti. In termini di incidenza, si stima che vi siano circa 3 000-5 000 nuovi casi di SM ogni anno in Francia e viene diagnosticato 1 caso ogni 5 minuti nel mondo (vale a dire 300 al giorno). La SM è una malattia cronica, poco letale e che spesso dura per diversi decenni. La SM causa un eccesso di mortalità che appare circa 10 anni dopo l’insorgenza della malattia e porta a un riduzione dell’aspettativa di vita di diversi anni rispetto alla popolazione generale. Questo eccesso di mortalità è dovuto alla SM stessa ma anche ad altre cause di decesso, il che sottolinea l’importanza della diagnosi e della gestione delle comorbilità e del rinforzo del ruolo della prevenzione (in particolare oncologica e cardiovascolare) nella gestione complessiva dei pazienti affetti da SM. Infine, benché l’origine della SM sia sempre sconosciuta, si può affermare che è una malattia multifattoriale, dovuta all’influenza di fattori ambientali combinata a una suscettibilità genetica, la cui equazione esatta non è ancora conosciuta fino a oggi.

Air pollution (indoors and outdoors) is a major issue in public health as epidemiological studies have highlighted its numerous detrimental health consequences (notably, respiratory and cardiovascular pathological conditions). Over the past 15years, air pollution has also been considered a potent environmental risk factor for neurological diseases and neuropathology. This review examines the impact of air pollution on children's brain development and the clinical, cognitive, brain structural and metabolic consequences. Long-term potential consequences for adults’ brains and the effects on multiple sclerosis (MS) are also discussed. One challenge is to assess the effects of lifetime exposures to outdoor and indoor environmental pollutants, including occupational exposures: how much, for how long and what type. Diffuse neuroinflammation, damage to the neurovascular unit, and the production of autoantibodies to neural and tight-junction proteins are worrisome findings in children chronically exposed to concentrations above the current standards for ozone and fine particulate matter (PM2.5), and may constitute significant risk factors for the development of Alzheimer's disease later in life. Finally, data supporting the role of air pollution as a risk factor for MS are reviewed, focusing on the effects of PM10and nitrogen oxides.

Multiple sclerosis (MS) is the most frequently seen demyelinating disease, with a prevalence that varies considerably, from high levels in North America and Europe (>100/100,000 inhabitants) to low rates in Eastern Asia and sub-Saharan Africa (2/100,000 population). Knowledge of the geographical distribution of the disease and its survival data, and a better understanding of the natural history of the disease, have improved our understanding of the respective roles of endogenous and exogenous causes of MS. Concerning mortality, in a large French cohort of 27,603 patients, there was no difference between MS patients and controls in the first 20 years of the disease, although life expectancy was reduced by 6–7 years in MS patients. In 2004, the prevalence of MS in France was 94.7/100,000 population, according to data from the French National Health Insurance Agency for Salaried Workers (Caisse nationale d’assurance maladie des travailleurs Salariés[CNAM-TS]), which insures 87% of the French population. This prevalence was higher in the North and East of France. In several countries, including France, the gender ratio for MS incidence (women/men) went from 2/1 to 3/1 from the 1950s to the 2000s, but only for the relapsing–remitting form. As for risk factors of MS, the most pertinent environmental factors are infection with Epstein-Barr virus (EBV), especially if it arises after childhood and is symptomatic. The role of smoking in MS risk has been confirmed, but is modest. In contrast, vaccines, stress, traumatic events and allergies have not been identified as risk factors, while the involvement of vitamin D has yet to be confirmed. From a genetic point of view, the association between HLA-DRB1*15:01 and a high risk of MS has been known for decades. More recently, immunogenetic markers have been identified (IL2RA, IL7RA) and, in particular thanks to studies of genome-wide associations, more than 100 genetic variants have been reported. Most of these are involved in the immune response and often associated with other autoimmune diseases. Studies of the natural history of MS suggest it is a two-phase disease: in the first phase, inflammation is focal with flares; and in the second phase, disability progresses independently of focal inflammation. This has clear implications for therapy. Age may also be a key factor in the phenotype of the disease. In conclusion, France is a high-risk country for MS, but it only slightly reduces life expectancy. MS is a multifactorial disease and the implications of immunogenetics are major. Preventative approaches might be derived from knowledge of the risk factors and natural history of the disease (smoking, vitamin D).

Background: Most data regarding the use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) comes from clinical series or regional databases that have a risk of recruitment bias. French health administrative data offers the significant advantage of being extensive in regards to both MS population coverage and DMT prescriptions.

La sclérose en plaques (SEP) est une affection neurologique qui débute souvent entre 20 ans et 40 ans, touche deux à trois femmes pour un homme et réduit l’espérance de vie de 6–7 ans. En France, elle touche 100 000 personnes, dont 80 % de 20–64 ans. Cette maladie chronique est handicapante et a donc des implications sur la vie professionnelle. Or, peu d’études sont disponibles pour mesurer ces effets, aucune sur un échantillon aléatoire représentatif. L’objectif de notre étude est de quantifier l’impact de la SEP sur le parcours professionnel à court et moyen termes.

Multiple sclerosis (MS) is a chronic neurological disease starting in young adulthood and leading to disability on the long-term. Persons with MS (PwMS) require multidisciplinary care involving general practitioners (GPs), neurologists as well as specialists of disability symptoms (frequently, physical medicine and rehabilitation physician, urologist, and ophthalmologist). The coordination and succession of these interventions constitute the care pathway of a patient. Even if a care pathway is unique for each patient, patterns of pathway can emerge. Identification of such patterns may be helpful for optimizing comprehensive care for PwMS and understanding variations within practices (if any). There is a current lack of statistical or epidemiological methods allowing for identification of such patterns. Therefore, we propose an innovative method, which is derived from social sciences: the multichannel sequence analysis (MCSA).

β-cyclodextrin derivatives having azido, amino and bioactive galactosylamido spacer functions were tested for haemolytic effect and compared with that of hydroxypropyl-β-cyclodextrin. The cyclodextrin coupled to the bioactive saccharide galactose via a spacer and which has bio-recognition properties for cell-wall lectin shows an extremely reduced haemolytic effect.

La sclérose en plaques (SEP) est une maladie chronique du jeune adulte affectant 100 000 personnes en France et entraînant une consommation de soins importante. L’ouverture récente des bases médico-administratives de l’Assurance maladie aux chercheurs, telle que l’EGB (Échantillon généraliste des bénéficiaires), permet l’accès à ces données de consommation. Cette étude pilote visait à décrire les parcours de soins des bénéficiaires de l’EGB atteints de SEP sur la période 2007-2013, puis à créer une typologie et à la caractériser par des facteurs individuels et contextuels.

Décrire l’utilisation des traitements de fond chez les patients ayant une sclérose en plaques (SEP) rémittente en France entre 1990 et 2017 : quels traitements ? À quel moment ? Combien de temps ? Quels changements ?

Le Teriflunomide (TRF) et le Dimethyl-Fumarate (DMF) sont deux traitements approuvés de 1religne pour la forme rémittente de sclérose en plaques (SEP). Cependant, à ce jour, il n’existe aucun essai randomisé ni aucune étude observationnelle comparant leur efficacité relative.

Les comorbidités mentales sont davantage fréquentes chez les patients atteints de la sclérose en plaques (SEP) qu’en population générale. En France, aucune donnée n’est disponible pour appuyer ce constat. Notre étude vise à estimer leur fréquence chez les patients atteints de SEP comparée à celles de groupes témoins (« sain » ou avec une affection longue durée [ALD] pour polyarthrite rhumatoïde [PR]), en France, à partir des données de l’Assurance maladie.

La sclérose en plaques (SEP) est une maladie chronique nécessitant une prise en charge pluridisciplinaire complexe. Cette étude vise à identifier et caractériser une typologie de parcours de soins des patients ayant une SEP en France.

La sclérose en plaques (SEP) est une maladie chronique entraînant sur le long terme l’apparition d’un handicap moteur mesurable par l’échelle Expanded Disability Status Scale(« EDSS »). Les bases de données de l’Assurance maladie ne contenant pas de données cliniques, cette étude vise à étudier la possibilité d’estimer le niveau de handicap moteur de patients atteints de SEP à partir de données de l’Assurance maladie en France.