Epidemiology and healthcare access in Brazilian multiple sclerosis patients: insights from the BRANDO database

Abstract

Background Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder whose prevalence varies across Brazil (from 15–27 cases per 100 thousand inhabitants), and the absence of an extensive national study limits the understanding of MS epidemiology in a nation as diverse as Brazil. Objective To compare epidemiological data, including healthcare access, among people with MS across four Brazilian regions. Methods Data from 2,974 Brazilian MS patients in the Collaborative Latin Ameri can Database for Multiple Sclerosis (BRANDO) were analyzed. We assessed demo graphic and clinical outcomes, as well as healthcare access, to elucidate regional differences. Results Thecohortwaspredominantlycomposedoffemalepatients(72.5%)withMS onsetatameanageof30.6years.Regardingtheregionaldifferences,therewasalower predominanceoffemalepatients(68.7%;p¼0.003)intheSoutheast,ahigherrateof subjectsofmixedethnicity(p<0.001)intheMidwest(40.3%)andNortheast(63.7%), higher scoresontheExpandedDisabilityStatusScale(EDSS) intheNortheast (4.0; p<0.001),ahigherprevalenceofrelapsing-remittingMS(RRMS)intheSoutheastand Midwest(87%;p<0.001),whiletheNortheastpresented(p<0.001)thehighestrates of primary progressiveMS (PPMS) and secondary progressiveMS (SPMS) (PPMS ¼15.8%; SPMS¼18%). The Northeast presented the longest time (5.9 years; p<0.01) fromdiseaseonsetuntilMSdiagnosis (rangefor theother regions¼1.9 3.7years). AndtheMidwest showedtheshortest time (2.1years; p<0.01) from diseaseonsetuntil firstaccess todisease-modifyingtherapies (DMTs; rangefor the otherregions¼3.5–5.1years). Conclusion Thepresentisthefirstnationwideepidemiologicalstudyonpeoplewith MS inBrazil. It underscores regional epidemiological variations anddifferences in healthcare access, advocating for tailored approaches in MS management and research.