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Source: Noonan CW, et al. Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology. 2002;58:136-138.
Investigators at the National Center for Health Statistics in Atlanta, Ga, analyzed data from 1982-1996 in the National Health Interview Survey (NHIS) which is conducted annually among a probability sample of the US population. Overall prevalence data and analyses for geographic, sex, age, and race/ethnicity distributions were performed. The overall prevalence estimate was 85/100,000, or approximately 211,000 (± 20,000). A 50% increase was observed in the number of women reporting MS for 1991-1994 vs. 1982-1986. The observed trend in higher numbers of self-reported MS among women is consistent with recent observations of higher prevalence and incidence. The trend was strongest in women aged 40-59 years, and women reporting MS as a cause for limitation of activity. The variation in race was consistent (54% white, 25% black, 19% other) with prior reports, as was the estimates of geographic distribution, with the lowest prevalence in the South. Noonan and colleagues note limitations in the self-reported or family reported data that is not case confirmed with medical reports. Some of the increased prevalence trends may reflect greater patient awareness and more active physician diagnoses given the introduction of immunomodulatory therapies since 1993. Physicians may be more inclined to make a diagnosis, and at an earlier stage, as treatment options have increased. By previous surveys, however, as many as 14% of participants would be unaware of their diagnosis and unlikely to report their disease in a health interview. —Brian R. Apatoff.
Apatoff, MD, PhD, Associate Professor of Neurology, New York Presbyterian Hospital-Cornell Campus, is Assistant Editor of Neurology Alert.
Source: Bech E, et al. A randomized, double-blind, placebo-controlled MRI study of anti-herpes virus therapy in MS. Neurology. 2002;58:31-36.
In a controlled clinical trial by Bech and colleagues, 70 relapsing MS patients were randomized to either valacyclovir (1 gm po tid) or placebo. Monthly MRIs and clinical scoring were performed for 8 months (2 months baseline, 6 months treatment). There were no significant differences between the treated and placebo groups either in the primary outcome measure of new MRI lesions or in the number of clinical relapses. In a small subset analysis of patients with high baseline MRI activity, however, there appeared to be fewer new active MRI lesions in the valacyclovir arm. However, simple antiherpes viral agents that are currently available to treat HSV-1, 2, and 3 do not seem to be of benefit. —Brian R. Apatoff