The clinical course of multiple sclerosis patients in Hong Kong.
BACKGROUND
Multiple sclerosis (MS) has a low prevalence in Hong Kong.


OBJECTIVE
To reassess MS prevalence in Hong Kong and to examine associated risk factors for relapsing-remitting type MS patients to reach Kurtzke's Extended Disability Status Scale (EDSS) of 6.0, i.e. when walking aid was needed.


METHODS
Retrospective observational study on MS patients over 11 years.


METHODS
Three tertiary hospitals in Hong Kong.


RESULTS
A hundred and six patients were recruited. Female to male ratio was 3.2:1 and the prevalence was 4.8 per 100,000. 95 were relapsing-remitting (RR) type. The mean disease duration was 12.7 years (range: 1-45 years) and the duration of follow up was 11.0+/-0.8 (mean+/-SE) years. The initial mean EDSS was 1.59 and the latest mean EDSS was 4.26. 38 (40%) RR type MS patients progressed to EDSS 6.0 after a mean duration of 6.0 years. With Cox regression analysis, patients with older age (>35y) of onset (HR 2.57; 95% CI:1.29-5.11), higher EDSS of 2.0 or more upon presentation (HR 2.19; 95%CI: 1.12-4.26) were associated with progression to EDSS of 6.0, while there was a tendency towards slower disease progression for patients initially presenting with optic symptoms (HR 0.52; 95%CI: 0.23-1.16). The number of relapses and use of interferon could not be shown to have significant effect on disease progression.


CONCLUSIONS
The local period prevalence ratio of MS was 4.8 per 100,000. Older age of onset and higher EDSS upon initial presentation were independent predictors for progression to EDSS of 6.0.
Lau
Kwok-kwong
KK
Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong. dominickklau@hotmail.com
Wong
Winnie Wing-Yin
WW
Sheng
Bun
B
Yu
Ignatius Tak-Sun
IT
Fung
Bun-Hey
BH
Li
Ho-Lun
HL
Ma
Ka-Fai Johnny
KF
Wong
Lawrence Ka-Sing
LK
Li
Patrick Chung-Ki
PC
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D004185:Disability Evaluation; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors