Gender-affirming interventions and prognosis in multiple sclerosis.

IF 5

Multiple sclerosis (Houndmills, Basingstoke, England) Pub Date : 2025-06-03 DOI:10.1177/13524585251341174

Nur Neyal, Nabeela Nathoo, Elizabeth J Cathcart-Rake, Orhun H Kantarci, Burcu Zeydan

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Abstract

Background: Gender-affirming hormone therapy (GAHT) may increase multiple sclerosis (MS) risk, yet MS disease course among transgender and gender-diverse (TGD) individuals remains understudied. We aimed to evaluate the disease course in TGD individuals with MS (TGD-MS).

Methods: Seventeen TGD-MS were identified. Ten TGD-MS on GAHT (five transgender women with MS (TW-MS) and five transgender men with MS (TM-MS)) were investigated further for MS outcomes of symptomatic (clinical)/asymptomatic (radiological) disease activity and progressive MS (PMS) onset.

Results: TW-MS (mean = 54.5 years, range = 35.1-66.3) were older than TM-MS (39.2 years, range = 29.6-47.2) at last follow-up. MS onset was later in TW-MS (31.5 years, range = 25.1-39.1) than in TM-MS (21.0 years, range = 15.0-29.8). Three patients (one TW-MS, two TM-MS) experienced symptomatic activity after GAHT initiation (8-10 months); in two patients (one TW-MS, one TM-MS), this marked symptomatic MS onset. Seven patients (four TW-MS, three TM-MS) had ⩾1 clinical/radiological disease activity. Four had PMS; all were TW-MS. In three, GAHT initiation preceded PMS onset (1-5 years). Disability was higher in TW-MS than in TM-MS.

Conclusion: MS disease course may be modified by GAHT and may differ between TW-MS and TM-MS, highlighting the need for larger long-term studies to overcome disparities in MS care. Comprehensive GAHT history, timely management, and closer follow-up are warranted in TGD-MS.

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性别肯定干预和多发性硬化症的预后。

背景：性别确认激素治疗（GAHT）可能增加多发性硬化症（MS）的风险，但变性人和性别多样化（TGD）个体的MS病程仍未得到充分研究。我们的目的是评估TGD患者合并MS （TGD-MS）的病程。方法：鉴定17个TGD-MS。对10例TGD-MS（5名变性MS女性（TW-MS）和5名变性MS男性（TM-MS））进行了进一步的MS结局调查，包括症状（临床）/无症状（放射学）疾病活动性和进展性MS （PMS）发病。结果：TW-MS（平均54.5岁，范围35.1 ~ 66.3岁）比TM-MS（39.2岁，范围29.6 ~ 47.2岁）年龄大。TW-MS的发病时间（31.5年，范围= 25.1-39.1）晚于TM-MS（21.0年，范围= 15.0-29.8）。3例患者（1例TW-MS， 2例TM-MS）在GAHT启动后（8-10个月）出现症状活动；在2例患者（1例TW-MS， 1例TM-MS）中，这标志着症状性MS发作。7名患者（4名TW-MS， 3名TM-MS）的临床/放射学疾病活动大于或等于1。4人有经前综合症；均为TW-MS。在3例中，经前症候群发病前（1-5年）就开始了GAHT治疗。TW-MS组致残率高于TM-MS组。结论：GAHT可能改变多发性硬化症病程，并且在TW-MS和TM-MS之间可能存在差异，强调需要更大规模的长期研究来克服多发性硬化症治疗的差异。在TGD-MS中，需要全面的gat病史，及时的管理和更密切的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Multiple sclerosis (Houndmills, Basingstoke, England)

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