Article Dans Une Revue Multiple Sclerosis Journal Année : 2024

Association between education level and disability progression in patients with multiple sclerosis in France

1 EHESP - École des Hautes Études en Santé Publique [EHESP]
2 ARENES - Arènes: politique, santé publique, environnement, médias
3 RSMS - Recherche sur les services et le management en santé
4 METIS - Département Méthodes quantitatives en santé publique
5 Service Microbiologie, Centre Hospitalier Universitaire de Caen
6 ANTICIPE - Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers
7 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
8 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
11 CHU Clermont-Ferrand
12 Neuro-Dol - Neuro-Dol
13 Centre d’Investigation Clinique Plurithématique (CIC - P) - CIC Strasbourg
14 CHU Nancy - Centre Hospitalier Universitaire de Nancy
15 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
16 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
17 UM - Université de Montpellier
18 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
19 CIC 0004 - Nantes - Centre d'investigation clinique (CIC) de Nantes -CIC Plurithématique
20 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
21 CIC - Centre d'Investigation Clinique [Rennes]
22 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
23 CHU Nice - Centre Hospitalier Universitaire de Nice
24 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
25 TIMONE - Hôpital de la Timone [CHU - APHM]
26 CHU de Bordeaux Pellegrin [Bordeaux]
27 U1215 Inserm - UB - Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
28 IGF - Institut de Génomique Fonctionnelle
29 HCL - Hospices Civils de Lyon
30 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
31 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
32 LilNCog - Lille Neurosciences & Cognition - U 1172
33 UNICAEN - Université de Caen Normandie
Pierre Clavelou
Jérôme de Sèze
Pierre Labauge
Jean Pelletier
Eric Thouvenot
Gilles Defer

Résumé

Background: Studies have reported an association between socioeconomic status and disability progression in multiple sclerosis (MS), but findings using the pre-MS individual socioeconomic status are missing. Objective: The objective was to investigate the association between education level and disability progression. Methods: All Observatoire Français de la Sclérose en Plaques (OFSEP) patients with MS clinical onset over 1960–2014, and aged ⩾25 years at MS onset were included. Education level was classified into four categories from low (primary/secondary school) to very high (master/doctoral degree). Time from MS onset to EDSS 4.0 was studied using flexible parametric survival models adjusted for age, period, and center, and stratified by phenotype (relapsing multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS)) and sex. Results: A total of 11,586 patients were included (women/men ratio = 2.5; age = 36.7 ± 8.6 years; follow-up duration 16.7 ± 9.3 years; 86.4% RMS). For women with RMS, the risk of reaching the outcome at 5 years was inversely associated with the education level (Hazard Ratio medium: 0.74 (0.63–0.87), high: 0.51 (0.43–0.62), very high: 0.39 (0.30–0.50) vs low). Results were similar for men. In PPMS, the risk was significantly different between the extreme groups (very high vs low) for women (0.45 (0.28–0.75)) and men (0.54 (0.32–0.91)), but no gradient was evident. Conclusion: Our study showed a strong association between education level and disability progression, regardless of sex and phenotype.
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hal-04814408 , version 1 (18-02-2025)

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Mathilde Lefort, Olivier Dejardin, Eric Berger, Jean-Philippe Camdessanché, Jonathan Ciron, et al.. Association between education level and disability progression in patients with multiple sclerosis in France. Multiple Sclerosis Journal, 2024, 31 (1), pp.59-68. ⟨10.1177/13524585241289274⟩. ⟨hal-04814408⟩
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