Epub ahead of print: Dobson et al. The effect of gender in clinically isolated syndrome (CIS): a meta-analysis. Mult Scler. 2011 Oct 12.
Background/Objective: A clinically isolated syndrome compatible with demyelination (CIS) is the initial presentation for the majority of people that go on to develop multiple sclerosis (MS). There has previously been little work examining the effect of gender on the development and progression of CIS.
Methods: Data from observational studies of CIS were used. In total, 33 suitable studies with 4732 subjects were identified.
Results: The overall relative risk (RR) of CIS in females compared with males was 2.12 (95% CI 1.94-2.32). The risk of females developing MS following CIS was 1.20 (95% CI 0.98-1.46) compared with males.
Conclusions: These data imply that the gender bias seen in MS is caused by factors acting early in the disease process.
“We all know MS is commoner in females and the incidence is increasing disproportionately in woman compared to men. What this study shows that even after the first clinical event a female is more likely to have a second event and develop definite MS; this is not surprising considering the increasing incidence in woman.”
“Is MS common enough in woman to be a pink ribbon disease or a possibly a variant of the pink ribbon? How about a pink polka dotted ribbon?”
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“I assume the MS Societies would go for orange and black.”
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CoI: This work was done in our group.
Prof G,Is CIS just another term for the first noticeable attack? Are there cases of people with CIS who never go on to develop MS (or do they get SPMS 20 years later)?Is any research being undertaken on CIS patients, given that this might give clues to what starts / triggers the disease?
Re: "Is CIS just another term for the first noticeable attack?""Yes, CIS is the term we use for the 1st attack.""Are there cases of people with CIS who never go on to develop MS (or do they get SPMS 20 years later)?"Unfortunately, yes. This is actually quite a common scenario. We used to refer to this type of MS as transitional MS and the attack as the sentinel attack. "Is any research being undertaken on CIS patients, given that this might give clues to what starts / triggers the disease?"Yes, there are several cohort studies that are ongoing in CIS. However, I believe that once someone has CIS they have the disease, which is why we are trying to focus on people who are at risk of MS before they develop CIS.
When you say you are trying to focus on people who are at risk of MS, is that in terms of treatment (to prevent them getting the disease), or in terms of understanding the factors which trigger it?
Re: "When you say you are trying to focus on people who are at risk of MS, is that in terms of treatment (to prevent them getting the disease), or in terms of understanding the factors which trigger it?"Both we need to understand how the risk factors interact with each other so that we can then plan a prevention study targeting very high risk subjects. I am betting in the biology giving us a deeper understanding of what causes MS and some clues to prevent it.
I hope your bet comes off and you are right as I'm sure you will be. As to the pink/orange debate, how i dislike that orange colour aaargh!!
Re: " how I dislike that orange colour aaargh!!"Any suggestions on which colours you would go for? Both the NMSS and the UK MS Society have gone with orange and black. I have thrown my hat into the MS Society lottery for a London Marathon place in 2012; the standard colour of their kit is orange and black.