Researchers observed an increased risk of sick leave in patients with MS several years before clinical onset of the disease.

Studies suggest that people who develop MS later often experience subtle symptoms in the preceding years, such as a somewhat higher rate of physician claims, hospital admission, and/or drug prescriptions [1]. A Swedish group examined yearly sickness absence rates of up to 10 years before MS onset, using administrative and registry data from their country [2]. Dr. Ali Manouchehrinia (Karolinska University, Sweden) said that the topic of prodromal MS is both intriguing and transformative in the understanding of MS, in the clinical management of MS, and in MS research. “A well-characterized prodromal phase of MS opens up a lot of opportunities for prevention strategies,” he stated.

A novel outcome that the researchers used was sickness absence benefits. Any resident in Sweden 16 years or older with income from work can obtain these benefits if their work capacity is reduced due to disease or injury. Two cohorts of patients were formed: cases identified via in/outpatient registries (administrative cohort) or via the Swedish MS registry (clinical cohort). The administrative cohort comprised 8,640 cases and 43,259 matched controls; the clinical cohort 6,527 cases and 32,589 controls.

The results showed that sickness absence rates steadily increase in the years leading up to the diagnosis of MS, starting to rise as early as 10–12 years before clinical onset in the administrative cohort. The rate ratio peaked in the year prior to MS onset, when it was about 2.5 times higher than in controls. The pattern was similar in the clinical cohort. Dr. Manouchehrinia concluded that analyzing and monitoring sick leave patterns may thus aid in timely MS diagnosis and intervention.

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