Nur Neyal, Nabeela Nathoo, Elizabeth J Cathcart-Rake, Orhun H Kantarci, Burcu Zeydan
{"title":"性别肯定干预和多发性硬化症的预后。","authors":"Nur Neyal, Nabeela Nathoo, Elizabeth J Cathcart-Rake, Orhun H Kantarci, Burcu Zeydan","doi":"10.1177/13524585251341174","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520714,"journal":{"name":"Multiple sclerosis (Houndmills, Basingstoke, England)","volume":" ","pages":"13524585251341174"},"PeriodicalIF":5.0000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gender-affirming interventions and prognosis in multiple sclerosis.\",\"authors\":\"Nur Neyal, Nabeela Nathoo, Elizabeth J Cathcart-Rake, Orhun H Kantarci, Burcu Zeydan\",\"doi\":\"10.1177/13524585251341174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":520714,\"journal\":{\"name\":\"Multiple sclerosis (Houndmills, Basingstoke, England)\",\"volume\":\" \",\"pages\":\"13524585251341174\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multiple sclerosis (Houndmills, Basingstoke, England)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/13524585251341174\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple sclerosis (Houndmills, Basingstoke, England)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/13524585251341174","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Gender-affirming interventions and prognosis in multiple sclerosis.
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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