Publications by authors named "Hillert J"

The prodromal features of multiple sclerosis (MS) are non-specific and are prevalent in the general population. Several studies indicate an increased use of healthcare resources by individuals with MS in the years preceding their diagnosis, suggesting a trend of deteriorating health prior to the clinical manifestation of MS. This study aimed to capture the possible associations of sick leave with the timing of the diagnosis of MS.

View Article and Find Full Text PDF

Purpose: Multiple sclerosis (MS) is often diagnosed in people of reproductive age. However, family planning counselling is not always integrated within MS care. Decisions on family planning can be further complicated by potential side effects associated with several disease-modifying therapies.

View Article and Find Full Text PDF

Background: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories.

View Article and Find Full Text PDF

Background And Objectives: While obesity is a known risk factor of the development of multiple sclerosis (MS), its impact on MS disease progression remains unclear. We aimed to investigate the influence of body mass index (BMI) on disease activity and progression, cognitive performance, and health-related quality of life in patients with MS.

Methods: Patients from an incident population-based case-control study (n = 3,249) were categorized based on BMI status at diagnosis and followed up after diagnosis through the Swedish MS registry.

View Article and Find Full Text PDF

Purpose: Understanding the long-term safety of disease-modifying therapies for multiple sclerosis (MS) in routine clinical practice can be undertaken through registry-based studies. However, variability of data quality across such sources poses the challenge of data fit for regulatory decision-making. CLARION, a non-interventional cohort safety study of cladribine tablets, combines aggregated data from MS registries/data sources, except in Germany (which utilizes primary data collection).

View Article and Find Full Text PDF
Article Synopsis
  • This study investigates the impact of alcohol consumption on disease progression and quality of life in patients with multiple sclerosis (MS), following a large group over 15 years.
  • Results indicate that low to moderate alcohol consumption is linked to a reduced risk of worsening disability, especially in women and those with relapsing-remitting MS, while high alcohol consumption showed no significant effects.
  • Researchers found that the beneficial effects of low to moderate drinking were more pronounced among patients who maintained their drinking habits over the study period, suggesting a consistent drinking pattern may contribute to better outcomes.
View Article and Find Full Text PDF

Multiple Sclerosis (MS) is a heterogeneous inflammatory and neurodegenerative disease with an unpredictable course towards progressive disability. Treating progressive MS is challenging due to limited insights into the underlying mechanisms. We examined the molecular changes associated with primary progressive MS (PPMS) using a cross-tissue (blood and post-mortem brain) and multilayered data (genetic, epigenetic, transcriptomic) from independent cohorts.

View Article and Find Full Text PDF
Article Synopsis
  • Multiple sclerosis (MS) is influenced by genetic and environmental factors, with viruses like Epstein-Barr and potentially rubella virus (RV) being linked to increased risk.
  • This study analyzed the immune response to RV in a Swedish cohort, comparing serological responses in individuals before MS onset, both vaccinated and unvaccinated against RV.
  • Results showed that unvaccinated individuals with RV seropositivity had a significantly higher risk of developing MS, suggesting a potential role of rubella virus in MS development, possibly through mechanisms like molecular mimicry with nervous system components.
View Article and Find Full Text PDF
Article Synopsis
  • * The initiative has formed four working groups aimed at enhancing research, clinical management, eHealth, and healthcare system reforms, ensuring a collaborative effort among patients, caregivers, and other stakeholders.
  • * As it progresses, the initiative plans to boost the use of eHealth tools and passive PROs in research and clinical settings, while also refining statistical methods in clinical trials and fostering alignment among industry, regulatory bodies, and health policymakers regarding PROs in MS healthcare.
View Article and Find Full Text PDF

In Sweden's universal healthcare system, it is unknown whether people of higher socioeconomic status receive higher quality multiple sclerosis (MS) care. Using linked clinical and administrative data, we investigated the quality of care received by 4426 adults aged 23-60 with relapsing-remitting MS. In adjusted analyses, we demonstrated that higher premorbid educational attainment is associated with 4-12 % more frequent neurologist visits and MRI scans in the first four years post diagnosis, while higher premorbid income was associated with faster diagnosis-to-treatment times by 34-64 days.

View Article and Find Full Text PDF
Article Synopsis
  • This study evaluated the effectiveness and safety of low-dose rituximab compared to standard therapies for treating multiple sclerosis (MS) in a Swedish cohort.
  • Over 4,900 participants were analyzed, revealing that rituximab had similar rates of disability progression and MS Impact Scale improvements compared to approved treatments.
  • Although rituximab showed lower relapse rates and better treatment adherence, it was linked to a higher risk of infections, particularly when switched from other therapies.
View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed how the COVID-19 pandemic affected the working lives of people with multiple sclerosis (PwMS) by surveying individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry.
  • - Out of over 8500 invited, 3887 respondents participated, with 93.7% being in paid work; 26.2% reported a specific impact from the pandemic, which varied by sex, MS severity, education, and profession.
  • - Key themes from respondents included direct occupational impacts, issues related to disclosing or concealing their condition at work, feelings of worry and uncertainty, and broader life changes; overall, many PwMS experienced little disruption to their work.
View Article and Find Full Text PDF

Background: Few studies have examined the effect of concomitant autoimmune diseases on multiple sclerosis (MS) disability worsening. We set out to examine whether concomitant Crohn's Disease (CD), Ulcerative Colitis (UC), or Type 1 Diabetes (T1D) affect MS disability worsening in a nationwide cohort of MS patients as defined by reaching expanded disability scale status (EDSS) scores 3.0, 4.

View Article and Find Full Text PDF

Background: The risk of coronavirus disease 2019 among people with multiple sclerosis with different disease-modifying therapies is not well established.

Objective: To investigate the occurrence of coronavirus disease 2019 and the remaining symptoms among people with multiple sclerosis and the associations with different disease-modifying therapies.

Methods: Individuals aged 20-50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in a survey in 2021.

View Article and Find Full Text PDF

Epstein-Barr virus (EBV) infection has been advocated as a prerequisite for developing multiple sclerosis (MS) and possibly the propagation of the disease. However, the precise mechanisms for such influences are still unclear. A large-scale study investigating the host genetics of EBV serology and related clinical manifestations, such as infectious mononucleosis (IM), may help us better understand the role of EBV in MS pathogenesis.

View Article and Find Full Text PDF

Background: The Big Multiple Sclerosis Data (BMSD) network ( https://bigmsdata.org ) was initiated in 2014 and includes the national multiple sclerosis (MS) registries of the Czech Republic, Denmark, France, Italy, and Sweden as well as the international MSBase registry. BMSD has addressed the ethical, legal, technical, and governance-related challenges for data sharing and so far, published three scientific papers on pooled datasets as proof of concept for its collaborative design.

View Article and Find Full Text PDF

Purpose Of Review: Web-based programs to prevent sexual offense perpetration could provide an opportunity that avoids many of the barriers associated with in-person treatment. The aim of this systematic review is to give an overview of the literature on web-based initiatives aimed at sexual offense perpetration prevention published during the last 10 years (2013-2023) and to report data on the efficacy as well as issues of the discussed initiatives.

Recent Findings: We included 18 empirical studies discussing web-based perpetration prevention initiatives, of which six are randomized controlled trials.

View Article and Find Full Text PDF
Article Synopsis
  • There isn't enough good information about choosing birth control for people with multiple sclerosis (MS).
  • An expert group from around the world created guidelines to help doctors talk to their patients about family planning and contraception.
  • They came up with 24 important suggestions about when and how to discuss birth control, what kinds are safe, and how to choose the best options for different patients.
View Article and Find Full Text PDF

Bipolar disorder (BD) is a heritable mental illness with complex etiology. While the largest published genome-wide association study identified 64 BD risk loci, the causal SNPs and genes within these loci remain unknown. We applied a suite of statistical and functional fine-mapping methods to these loci, and prioritized 17 likely causal SNPs for BD.

View Article and Find Full Text PDF

Background And Objectives: Clinical onset of multiple sclerosis (MS) after the age of 50 years is uncommon and associated with a less favorable natural history. The differences in long-term outcomes in patients with late-onset MS (LOMS, onset 50 years or older) and adult-onset MS (AOMS, onset 18 years or older and younger than 50 years) during the disease-modifying therapy (DMT) era have been less studied. This study aimed to compare patient characteristics, DMT exposure, and disability progression in Swedish patients with LOMS and AOMS over 2 decades (2001-2022).

View Article and Find Full Text PDF
Article Synopsis
  • Disease-modifying therapies (DMTs) have positively impacted the health and work productivity of individuals with multiple sclerosis (PwMS) in Sweden, leading to the study of their usage patterns.
  • A study analyzed DMT use trajectories among 1,395 PwMS starting treatment in 2014/2015 and found four distinct clusters of DMT usage, linking higher disability to some of these clusters.
  • Results indicated that PwMS on high-efficacy DMTs had a greater reduction in sickness absence and disability pension trends compared to those on lower-efficacy treatments, suggesting better outcomes for those starting high-efficacy therapies.
View Article and Find Full Text PDF
Article Synopsis
  • The study aims to identify predictors of treatment switching in patients with relapsing-remitting MS using data from multiple national registries.
  • A total of 269,822 treatment episodes from 110,326 patients were analyzed, focusing on those who started disease-modifying treatments during their RRMS phase.
  • Key findings indicate that higher disability scores (EDSS), being female, and older age increase the likelihood of treatment switching, with certain DMTs initiated between 2007 and 2012 showing even higher rates of switching.
View Article and Find Full Text PDF
Article Synopsis
  • - As of September 2022, a lack of standardized core data elements for multiple sclerosis (MS) hindered effective data sharing and collaboration in healthcare and research.
  • - A global task force of 20 experts developed a core dataset of 44 variables in eight categories to improve data consistency from real-world data sources, which includes demographic information, disease history, MRI results, and treatment details.
  • - The resulting MS Data Alliance Core Dataset aims to assist newly formed and existing registries, promoting data harmonisation and improving research outcomes in the field of MS.
View Article and Find Full Text PDF

Objective: There has been interest in a possible negative association between HIV and multiple sclerosis (MS). We aimed to compare the risk of MS in a cohort of individuals living with HIV to that in the general population.

Methods: Population-based health data were accessed for 2 cohorts of HIV-positive persons from Sweden and British Columbia, Canada.

View Article and Find Full Text PDF

Introduction: Prescribing guidance for disease-modifying treatment (DMT) in multiple sclerosis (MS) is centred on a clinical diagnosis of relapsing-remitting MS (RRMS). DMT prescription guidelines and monitoring vary across countries. Standardising the approach to diagnosis of disease course, for example, assigning RRMS or secondary progressive MS (SPMS) diagnoses, allows examination of the impact of health system characteristics on the stated clinical diagnosis and treatment access.

View Article and Find Full Text PDF