Poverty is the "original sin", and rare diseases are no exception! The Lancet: Excess death in patients with low socioeconomic status or increased MS!

Multiple sclerosis (MS) affects 2.
8 million people worldwide, and life expectancy for people with MS is reduced by 6-14 years
compared to the age- and sex-matched general population.
There are few known risk factors for death from MS, mainly age and sex of MS, both of which are unmodifiable risk factors
.
To date, no conclusive results
have been found regarding the risks and socioeconomic factors of developing MS.

Excess mortality can be used to derive net survival, i.
e.
survival that can be observed if the disease studied is the only possible cause of death in the population
.
To date, no studies on socioeconomic predictors have been published to study excess mortality
in MS patients in the general population.
The aim of this study was to examine mortality due to MS using the excess hazard framework and additive model to estimate excess mortality based on socioeconomic deprivation
.

A total of 34,169 patients with multiple sclerosis (88% recurrent onset (n = 30083) and 12% progressive onset (n = 4086)) were included in this study, with a female/male sex ratio of 2.
7 recurrent onset and a female/male sex ratio of 1.
3
with progressive onset.
The mean age of onset of recurrent onset was 31.
6 (SD = 9.
8) and that of progressive onset was 42.
7 (SD = 10.
8).

At the end of follow-up, 1849 patients died (recurrent onset 4.
4% (n = 1311) and progressive onset 13.
2% (n = 538)).

socioeconomic gradients were found in relapsed patients; Patients with higher levels of poverty had higher
excess mortality.

For the difference in survival probability (or deprivation gap) between patients with mild recurrent episodes (EDI = −6) and more severe patients with recurrent episodes (EDI = 12) after 30 years of disease (1980 year of MS) onset), the difference in survival probability (or deprivation gap) between patients with milder recurrent episodes (EDI = −6) and those with more severe relapses (EDI = 12) was 16.
6% (95% confidence interval (CI) [10.
3%- 22.
9%]), 12.
3% (95% CI 7.
6% to 17.
0%) in women.

No significant socioeconomic mortality gradient was found in patients with progressive disease
.

Socioeconomic status is associated with mortality in patients with
recurrent multiple sclerosis.
Improving overall care for people with multiple sclerosis who are more socioeconomically deprived can help reduce socioeconomic inequalities
in multiple sclerosis-related mortality.

Original source:

Sarah Wilson, et al.
Effects of socioeconomic status on excess mortality in patients with multiple sclerosis in France: A retrospective observational cohort study.
The Lancet Regional Health - Europe 2023; 24: 100542 Published Online XXX https://doi.
org/10.
1016/j.
lanepe.
2022.
100542