Epidemiology of Multiple Sclerosis in Diverse Populations

Multiple sclerosis (MS) is a chronic, immune-mediated disease characterised by focal demyelination within the central nervous system. Epidemiological studies have long established a north–south gradient, with highest prevalence in northern Europe and North America and lower rates in equatorial regions. However, recent data reveal a more complex global picture: incidence and prevalence are rising in many previously low-risk areas, notably in parts of Asia and Latin America, as improved diagnostic capacity and standardised criteria become widespread. Female predominance, typically a 2–3:1 ratio, and peak onset in young adulthood remain consistent across settings, yet age at first presentation and clinical course vary by ethnicity and environment. Genetic predisposition, vitamin D exposure, viral infections and socioeconomic factors interact to shape regional disease burden. Advances in magnetic resonance imaging and refined diagnostic algorithms have enhanced case ascertainment, while electronic health records and insurance databases are uncovering previously unrecognised regional heterogeneities. Understanding these patterns is critical for resource allocation, tailoring of preventive strategies and equitable access to disease-modifying therapies. Cross-regional comparisons highlight not only disparities in incidence but also differences in healthcare utilisation, treatment uptake and long-term outcomes, emphasising the need for population-specific surveillance and intervention frameworks.

Research from Nature Portfolio

Real-world analysis of a nationwide insurance database in Taiwan has provided one of the most detailed epidemiological profiles in East Asia. Over a decade, crude incidence rates declined modestly from approximately 0.43 to 0.24 per 100,000 persons, while female to male ratios remained stable at around 2.5. Initial use of interferon β-1a dominated first-line treatment, with nearly four-fifths of patients receiving this therapy. Uptake of newer agents such as fingolimod grew over time, accounting for over one third of second-line prescriptions. Median intervals from diagnosis to treatment initiation lengthened beyond 70 days for first-line agents and exceeded three years for subsequent therapies, indicating barriers to swift access. These findings underscore both the success of immunotherapy in reducing relapse rates and the persistent need to shorten delays in treatment commencement.

Epidemiology of Multiple Sclerosis in Diverse Populations publication trend

The graph below shows the total number of articles in epidemiology of multiple sclerosis in diverse populations across all publications each year (not limited to Nature Index journals).

Technical terms

Incidence: Number of new cases of a disease occurring in a specified population per unit of time, typically expressed per 100,000 person-years.

Prevalence: Proportion of individuals in a population who have a particular disease at a given time, usually reported per 100,000 persons.

Disease-Modifying Therapy (DMT): Pharmacological agents intended to alter the underlying course of multiple sclerosis, reducing relapse frequency and delaying disability progression.

Disability-Adjusted Life Year (DALY): A composite measure of disease burden, calculated as the sum of years of life lost due to premature mortality and years lived with disability, adjusted for severity.

References

1. Incidence of multiple sclerosis in China: A nationwide hospital-based study. The Lancet Regional Health - Western Pacific (2020).
2. Multiple Sclerosis in the Asia Pacific Region: A Systematic Review of a Neglected Neurological Disease. Frontiers in Neurology (2018).
3. A multicenter study to evaluate the disease burden and health economics of inpatients with multiple sclerosis in China. Multiple Sclerosis and Related Disorders (2022).
4. Epidemiology, treatment patterns and healthcare utilizations in multiple sclerosis in Taiwan. Scientific Reports (2021).