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Abstract

Background and Objectives

Antitumor necrosis factor α (TNFα) agents are a class of biologic drugs used for the treatment of several immune-mediated conditions. An increased risk of multiple sclerosis (MS) with their use has been suggested, but studies have been limited. Relevant population-based epidemiologic data linking anti-TNFα to MS are scarce. The objective was to compare the risk of MS in anti-TNFα users with nonusers among patients with rheumatic disease (RD) or inflammatory bowel disease (IBD).

Methods

A nested case-control study was conducted. Population-based health care–linked databases from 4 Canadian provinces were used. All patients with RD or IBD residing within a participating province between January 2000 and March 2018 were identified by validated case definitions. Any anti-TNFα dispensation in the 2 years before the index date (MS onset) was identified. Incident onset MS cases were ascertained using a validated algorithm. Up to 5 controls were matched to each MS case based on birth year ±3 years, disease duration, and health authority (based on region of residence). Conditional logistic regressions were used to calculate the incidence rate ratio (IRR) after adjusting for potential confounders. A meta-analysis was conducted to provide pooled estimates across provinces using random-effects models.

Results

Among 296,918 patients with RD patients, 462 MS cases (80.1% female, mean [SD] age, 47.4 [14.6] years) were matched with 2,296 controls (59.5% female, mean [SD] age, 47.4 [14.5] years). Exposure to anti-TNFα occurred in 18 MS cases and 42 controls. After adjusting for matching variables, sex, and the Charlson Comorbidity Index, the pooled IRR was 2.05 (95% CI, 1.13–3.72). Among 84,458 patients with IBD, 190 MS cases (69.5% female, mean [SD] age, 44.3 [12.3] years) were matched with 943 controls (54.1% female, mean [SD] age, 44.2 [12.2] years). Exposure to anti-TNFα occurred in 23 MS cases and 98 controls. The pooled adjusted IRR was 1.35 (95% CI, 0.70–2.59).

Discussion

The use of anti-TNFα was associated with an increased risk of MS compared with nonusers, especially among patients with RD. These findings could help clinicians and patients with RD to make more informed treatment decisions. Further studies are needed to validate these results for patients with IBD.

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References

1.
McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325(8):765-779.
2.
Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition. Mult Scler. 2020;26(14):1816-1821.
3.
Feagan BG, Patel H, Colombel JF, et al. Effects of vedolizumab on health-related quality of life in patients with ulcerative colitis: results from the randomised GEMINI 1 trial. Aliment Pharmacol Ther. 2017;45(2):264-275.
4.
Keystone EC, Kavanaugh AF, Sharp JT, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled. Arthritis Rheum. 2004;50(5):1400-1411.
5.
Loftus EV, Feagan BG, Colombel JF, et al. Effects of adalimumab maintenance therapy on health-related quality of life of patients with Crohn's disease: patient-reported outcomes of the CHARM trial. Am J Gastroenterol. 2008;103(12):3132-3141.
6.
Holdam ASK, Bager P, Dahlerup JF. Biological therapy increases the health-related quality of life in patients with inflammatory bowel disease in a clinical setting. Scand J Gastroenterol. 2016;51(6):706-711.
7.
Boggs JME, Barnes L. Demyelination during anti-tumour necrosis factor therapy for psoriasis. Clin Exp Dermatol. 2018;43(5):577-578.
8.
Theibich A, Dreyer L, Magyari M, Locht H. Demyelinizing neurological disease after treatment with tumor necrosis factor alpha-inhibiting agents in a rheumatological outpatient clinic: description of six cases. Clin Rheumatol. 2014;33(5):719-723.
9.
Chey SY, Kermode AG. Central nervous system demyelination related to tumour necrosis factor Alpha inhibitor. Mult Scler J Exp Transl Clin. 2022;8(1):20552173211070750.
10.
Hutto SK, Rice DR, Mateen FJ. CNS demyelination with TNFα inhibitor exposure: a retrospective cohort study. J Neuroimmunol. 2021;356:577587.
11.
Kemanetzoglou E, Andreadou E. CNS demyelination with TNF-α blockers. Curr Neurol Neurosci Rep. 2017;17(4):36.
12.
TNF neutralization in MS: results of a randomized, placebo-controlled multicenter study. The lenercept multiple sclerosis study group and the university of British Columbia MS/MRI analysis group. Neurology. 1999;53(3):457-465.
13.
Kunchok A, Aksamit AJ, Davis JM, et al. Association between tumor necrosis factor inhibitor exposure and inflammatory central nervous system events. JAMA Neurol. 2020;77(8):937-946.
14.
Bernatsky S, Renoux C, Suissa S. Demyelinating events in rheumatoid arthritis after drug exposures. Ann Rheum Dis. 2010;69(9):1691-1693.
15.
Kopp TI, Delcoigne B, Arkema EV, et al. Risk of neuroinflammatory events in arthritis patients treated with tumour necrosis factor alpha inhibitors: a collaborative population-based cohort study from Denmark and Sweden. Ann Rheum Dis. 2020;79(5):566-572.
16.
Dreyer L, Magyari M, Laursen B, Cordtz R, Sellebjerg F, Locht H. Risk of multiple sclerosis during tumour necrosis factor inhibitor treatment for arthritis: a population-based study from DANBIO and the Danish Multiple Sclerosis Registry. Ann Rheum Dis. 2016;75(4):785-786.
17.
Taylor TRP, Galloway J, Davies R, Hyrich K, Dobson R. Demyelinating events following initiation of anti-TNFα therapy in the British Society for Rheumatology biologics registry in rheumatoid arthritis. Neurol Neuroimmunol Neuroinflammation. 2021;8(3):e992.
18.
AlQassimi S, AlBrashdi S, Galadari H, Hashim MJ. Global burden of psoriasis—comparison of regional and global epidemiology, 1990 to 2017. Int J Dermatol. 2020;59(5):566-571.
19.
Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769-2778.
20.
Safiri S, Kolahi AA, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis. 2019;78(11):1463-1471.
21.
Crossfield SSR, Marzo-Ortega H, Kingsbury SR, Pujades-Rodriguez M, Conaghan PG. Changes in ankylosing spondylitis incidence, prevalence and time to diagnosis over two decades. RMD Open. 2021;7(3):1-8.
22.
British Columbia Ministry of Health [creator]: Medical services plan (MSP) payment information file. Population Data BC [publisher]. Data extract. MOH; 2017. popdata.bc.ca/data/health/msp. Accessed April 06, 2022.
23.
Canadian Institute for Health Information [creator](2017): Discharge Abstract Database (Hospital Separations). Population Data BC [publisher]. Data Extract. MOH; 2017). popdata.bc.ca/data/health/dad. Accessed April 06, 2022.
24.
British Columbia Ministry of Health [creator]: Consolidation file (MSP registration & premium billing). Population Data BC [publisher]. Data Extract. MOH; 2017. popdata.bc.ca/data/population/consolidationfile. Accessed April 06, 2022.
25.
British Columbia Ministry of Health [creator]. 2018. PharmaNet. Population Data BC [publisher]. Data Extract. Data Stewardship Committee; 2017. popdata.bc.ca/data/health/PharmaNet. Accessed April 06, 2022.
26.
Li L, Lu N, Avina-Galindo AM, et al. The risk and trend of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a general population-based study. Rheumatology (Oxford). 2021;60(1):188-195.
27.
Coward S, Clement F, Benchimol EI, et al. Past and future burden of inflammatory bowel diseases based on modeling of population-based data. Gastroenterology. 2019;156(5):1345-1353.e4.
28.
Hitchon CA, Khan S, Elias B, Lix LM, Peschken CA. Prevalence and incidence of rheumatoid arthritis in canadian first nations and non-first nations people: a population-based study. J Clin Rheumatol. 2020;26(5):169-175.
29.
Al-Sakran LH, Marrie RA, Blackburn DF, Knox KB, Evans CD. Establishing the incidence and prevalence of multiple sclerosis in saskatchewan. Can J Neurol Sci. 2018;45(3):295-303.
30.
Essebag V, Genest J, Suissa S, Pilote L. The nested case-control study in cardiology. Am Heart J. 2003;146(4):581-590.
31.
Aviña-Zubieta JA, Chan J, De Vera M, Sayre EC, Choi H, Esdaile J. Risk of venous thromboembolism in ankylosing spondylitis: a general population-based study. Ann Rheum Dis. 2019;78(4):480-485.
32.
Tan J, Avina-Zubieta JA, Dominique A, Tavakoli H, Simon TA. Risk of cancer in patients with psoriasis/psoriatic arthritis: a population-based study in the province of British Columbia [abstract]. Arthritis Rheumatol. 2018;70(suppl 10). acrabstracts.org/abstract/risk-of-cancer-in-patients-with-psoriasis-psoriatic-arthritis-a-population-based-study-in-the-province-of-british-columbia/. Accessed April 06, 2022.
33.
Rezaie A, Quan H, Fedorak RN, Panaccione R, Hilsden RJ. Development and validation of an administrative case definition for inflammatory bowel diseases. Can J Gastroenterol. 2012;26(10):711-717.
34.
Bernstein CN, Blanchard JF, Rawsthorne P, Wajda A. Epidemiology of Crohn's disease and ulcerative colitis in a central Canadian province: a population-based study. Am J Epidemiol. 1999;149(10):916-924.
35.
Wacholder S, Silverman DT, Mclaughlin JK, Mandel JS. Selection of controls in case-control studies: II. Types of controls. Am J Epidemiol. 1992;135(9):1029-1041.
36.
Etminan M, Sodhi M, Li L. Methodological considerations for the case-control study of metformin and age-related macular degeneration. JAMA Ophthalmol. 2021;139(8):918-919.
37.
Schisterman EF, Cole SR, Platf RW. Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology. 2009;20(4):488-495.
38.
Romano PS, Roos LL, Jollis JG. Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: differing perspectives. J Cin Epidemiol. 1993;46(10):1075-1079.
39.
Costa-Bouzas J, Takkouche B, Cadarso-Suárez C, Spiegelman D. HEpiMA: software for the identification of heterogeneity in meta-analysis. Comput Methods Programs Biomed. 2001;64(2):101-107.
40.
Bjerre LM, LeLorier J. Expressing the magnitude of adverse effects in case-control studies: “The number of patients needed to be treated for one additional patient to be harmed. BM J. 2000;320(7233):503-506.
41.
Van Der Weele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-Value. Ann Intern Med. 2017;167(4):268-274.
42.
Mathur MB, Ding P, Riddell CA, VanderWeele TJ. Website and R Package for computing E-values. Epidemiology. 2018;29(5):e45–e47.
43.
Tremlett H, Munger KL, Makhani N. The multiple sclerosis prodrome: evidence to action. Front Neurol. 2022;12:761408.
44.
Adar T, Faleck D, Sasidharan S, et al. Comparative safety and effectiveness of tumor necrosis factor α antagonists and vedolizumab in elderly IBD patients: a multicentre study. Aliment Pharmacol Ther. 2019;49(7):873-879.
45.
Emery P, Rondon J, Parrino J, et al. Safety and tolerability of subcutaneous sarilumab and intravenous tocilizumab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2019;58(5):849-858.

Information & Authors

Information

Published In

Neurology®
Volume 100Number 6February 7, 2023
Pages: e558-e567
PubMed: 36307225

Publication History

Received: May 27, 2022
Accepted: September 9, 2022
Published online: October 28, 2022
Published in print: February 7, 2023

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Disclosure

L. Li is supported by the Canadian Institutes of Health Research Fred Frederick Banting and Charles Best Canada Graduate Scholarships Doctoral Awards. J.A.Aviña-Zubieta is supported by the BC Lupus Society Scholar Award and is the Walter & Marilyn Booth Research Scholar. C. Bernstein reports no disclosures relevant to the manuscript. G.G. Kaplan has received honoraria for speaking or consultancy from AbbVie, Janssen, Pfizer, Amgen, and Takeda. He has received research support from Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire. He has been a consultant for Gilead. He shares ownership of a patent:treatment of inflammatory disorders, autoimmune disease, and PBC. UTI Limited Partnership, assignee. Patent WO2019046959A1. PCT/CA2018/051098. September 7, 2018. H. Tremlett reports no disclosures relevant to the manuscript. H. Xie reports no disclosures relevant to the manuscript. J.N. Peña-Sánchez reports no disclosures relevant to the manuscript. R.A. Marrie reports no disclosures relevant to the manuscript. M. Etminan reports no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.

Study Funding

Canadian Institutes of Health Research (CIHR Grant Numbers THC-135235 and PJT-166183).

Authors

Affiliations & Disclosures

Lingyi Li, MSc
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) Canadian Institutes of Health Research (CIHR grant number THC-135235 <br><br>and PJT-166183). 2019-2021<br><br><br><br>(2) Canadian Institutes of Health Research Fred Frederick Banting and Charles <br><br>Best Canada Graduate Scholarships Doctoral Awards. 2020-2023
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
J. Antonio Aviña-Zubieta, MD, MSc, PhD*
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Charles N. Bernstein, MD
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
Abbvie Canada, Amgen Canada, Avir Pharmaceuticals, <br>Bristol Myers Squibb Canada, Janssen Canada, Pfizer <br>Canada, Takeda Canada, Roche Canada, Sandoz Canada
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Speakers bureau for Abbvie Canada, Janssen Canada, Takeda <br>Canada, Pfizer Canada
Editorial Boards:
1.
Editorial Advisory board for Journal of Canadian <br>Association of Gastroenterology
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Takeda and Mylan Pharmaceuticals
Speakers' Bureaus:
1.
Speaker fees from Abbvie Canada, Takeda Canada, Janssen <br>Canada, Pfizer Canada
Other Activities:
1.
Education grants from Abbvie Canada, Janssen Canada, <br>Pfizer Canada, Takeda Canada
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Abbvie Canada, Sandoz Canada and Pfizer Canada have given <br>unrestricted investigator initiated grants
Research Support, Government Entities:
1.
Canadian Institutes of Health Research, Research Manitoba
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
legal consultant to Mylan Pharmaceuticals and Takeda and <br>3M
Gilaad G. Kaplan, MD, MPH
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Dr. Kaplan has received honoraria for speaking from AbbVie, <br>Janssen, Pfizer, Amgen, Sandoz, Pendophram, and Takeda.
Editorial Boards:
1.
Associate Editor, Gastroenterology
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Dr. Kaplan has received research support from Ferring.
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Helen Tremlett, PhD
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
All non-profit:<br><br>&#x0095; National US surveillance system for MS. 2013-2019. <br>Invited by the US National MS Society to form an <br>advisory <br>group to enable the development of a national <br>surveillance <br>system capable of tracking the incidence and prevalence <br>of <br>MS. Monthly teleconferences; one face-to-face meeting: <br>Atlanta, Georgia (March 2014)<br>Status: Bipartisan legislation introduced to Congress - <br>'Advancing Research for Neurological Diseases Act, H.R. <br>292.'to guide the Centers for Disease Control and <br>Prevention <br>in tracking the incidence and prevalence of neurological <br>diseases, including Multiple Sclerosis and Parkinson's <br>disease [13th-Jan-2015; http://burgess.house.gov/blog/?<br>postid=397459]
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Helen Tremlett has, in the last five years, received <br>research support from the Canada Research Chair Program, <br>the National Multiple Sclerosis Society, the Canadian <br>Institutes of Health Research, the Multiple Sclerosis <br>Society of Canada, the Multiple Sclerosis Scientific <br>Research Foundation and the EDMUS Foundation (&#x0091;Fondation <br>EDMUS contre la scl&#x00E9;rose en plaques&#x0092;). In addition, in the <br>last five years, has had travel expenses or registration <br>fees prepaid or reimbursed to present at CME conferences <br>from the Consortium of MS Centres (2018), National MS <br>Society (2016, 2018), ECTRIMS/ ACTRIMS (2015, 2016, 2017, <br>2018, 2019, 2020, 2021, 2022), American Academy of <br>Neurology (2015, 2016, 2019). Speaker honoraria are either <br>declined or donated to an MS charity or to an unrestricted <br>grant for use by HT&#x0092;s research group.<br>Research Support, Foundations and Societies: <br>Canada Foundation for Innovation (CFI); Canadian <br>Institutes <br>of Health Research [#363635 (co-PI); #190898 (PI); <br>#404791; <br>#387503; #388480 (all as PI); #MOP-82738 (PI) and MOP-<br>119393 (PI) and MOP-106607 (PI)]; <br>the US National Multiple Sclerosis Society (Operating <br>grants: 2012-15; 2014-17), the <br>Multiple Sclerosis Society of Canada (2015-19: EGID <br>#2624 <br>(PI); 2016-19: EGID #2680 (co-PI); ) the The Multiple <br>Sclerosis Scientific and Research Foundation (2015-21 <br>(PI)); Canada Research Chair in Neuroepidemiology and <br>Multiple Sclerosis
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Canada Foundation for Innovation (CFI); Canadian <br>Institutes <br>of Health Research [#363635 (co-PI); #190898 (PI); <br>#404791; <br>#387503; #388480 (all as PI); #MOP-82738 (PI) and MOP-<br>119393 (PI) and MOP-106607 (PI)]; <br>the US National Multiple Sclerosis Society (Operating <br>grants: 2012-15; 2014-17), the <br>Multiple Sclerosis Society of Canada (2015-19: EGID <br>#2624 <br>(PI); 2016-19: EGID #2680 (co-PI); ) the The Multiple <br>Sclerosis Scientific and Research Foundation (2015-21 <br>(PI)); Canada Research Chair in Neuroepidemiology and <br>Multiple Sclerosis
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Hui Xie, PhD
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Juan-Nicolás Peña-Sánchez, MD, PhD
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
(1) University of Saskatchewan
Research Support, Foundations and Societies:
1.
(1) Royal University Hospital Foundation (2) Saskatchewan <br>Health Research Foundation (3) Crohn's and Colitis Canada (4) <br>Canadian Institutes of Health<br>Research.
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Ruth Ann Marrie, MD, PhD
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
Multiple Sclerosis Journal, <br>Editorial Board<br>Multiple Sclerosis Journal-ETC, Co-Editor (ended Dec 2020)<br>Neurology, Editorial Board (2022)
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Roche Canada (no direct funding to me or my institution), <br>Biogen (no direct funding to me or my institution)
Research Support, Government Entities:
1.
Received support as principal <br>investigator from the<br>Canadian Institutes of Health <br>Research (2010-2023), and Research <br>Manitoba (2014-2022) and as co-investigator from US <br>Department of Defense (2020-2023).
Research Support, Academic Entities:
1.
Waugh Family Chair in Multiple Sclerosis
Research Support, Foundations and Societies:
1.
Received support as principal investigator from <br>Multiple Sclerosis Society of Canada (2009-2025) and the<br>National Multiple Sclerosis Society (2013-2023), and as <br>co-principal investigator from Multiple Sclerosis <br>Scientific Foundation (2009-2021). <br>Received support from <br>Consortium of Multiple Sclerosis Centers (2004-2009, <br>2011-2014, 2016-2022), Crohn's and Colitis Canada (2014-<br>2023), The Arthritis Society (2021-2023)
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Mahyar Etminan, PharmD, MSc*
From the Experimental Medicine Program (L.L., J.A.A.-Z., M.E.), Division of Rheumatology (J.A.A.-Z.), Department of Medicine, Division of Neurology (H.T.), Faculty of Medicine, and Departments of Ophthalmology and Visual Sciences (M.E.), Medicine and Pharmacology, University of British Columbia, Vancouver; Arthritis Research Canada (L.L., J.A.A.-Z., H.X.), Vancouver, British Columbia; Departments of Internal Medicine (C.N.B., R.A.M.) and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg; Departments of Medicine and Community Health Sciences (G.G.K.), University of Calgary, Alberta; The Djavad Mowafaghian Centre for Brain Health (H.T.), Vancouver, British Columbia; Faculty of Health Sciences (H.X.), Simon Fraser University, Burnaby, British Columbia; and Department of Community Health and Epidemiology (J.-N.P.-S.), College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
(1) Consulted in Propecia and Sexual Dysfuncation litigation <br>and Abilify and gambling litgation, 2017; (2) Consulted in <br>the Mirena and intracranial hypertension litigation, 2016

Notes

Correspondence Dr. Etminan [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
*
These authors contributed equally to this work.
Submitted and externally peer reviewed. The handling editor was Olga Ciccarelli, MD, PhD, FRCP.

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