{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:51:27Z","timestamp":1791204687883,"version":"4.2.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Patients With Multiple Sclerosis (\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      ) Have Higher Mortality Than Matched Background Populations. We Compare Relative and Excess Mortality in\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      Over the Matched Background Populations Between Primary Progressive\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">PPMS<\/jats:styled-content>\n                      ), relapsing Onset\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">ROMS<\/jats:styled-content>\n                      ), and Secondary Progressive\n                      <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">SPMS<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included all patients from the nationwide and complete Danish MS Registry with onset 1994\u20132022 and compared the extra mortality of the MS phenotypes in terms of relative and excess mortality, with adjustment for sex, age at onset, disease\u2010modifying treatment, and number of recorded relapses. We calculated the adjusted ratios of relative and excess mortalities between PPMS and ROMS and between PPMS and SPMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The initial course was unknown in 221, leaving 1412 cases with PPMS (which includes progressive relapsing MS) and 12,449 cases with ROMS. 627 had died during follow\u2010up by the end of 2022. After adjustment, both ratios between PPMS and ROMS came close to unity, indicating that the excess mortality is equal for PPMS and ROMS in the long run. The adjusted relative and additive mortalities were factors 6.05 (95% CI 4.42\u20138.27) and 1.90 (95% CI 1.65\u20132.18) higher in SPMS than in PPMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with the matched population, the adjusted relative and excess mortalities are the same for PPMS and ROMS. However, SPMS had a higher relative and excess mortality than PPMS, probably in part owing to the burden of disease carried over from the pre\u2010progressive phase. This underlines the need for effective treatment in this later stage of the disease and more attention to comorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70122","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T08:02:45Z","timestamp":1744876965000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Phenotypes of Multiple Sclerosis Differ Significantly in Relative and Excess Mortality"],"prefix":"10.1111","volume":"32","author":[{"given":"Melinda","family":"Magyari","sequence":"first","affiliation":[{"name":"The Danish Multiple Sclerosis Registry Copenhagen University Hospital\u2014Rigshospitalet  Copenhagen Denmark"},{"name":"Danish Multiple Sclerosis Center, Department of Neurology Copenhagen University Hospital\u2014Rigshospitalet  Glostrup Denmark"},{"name":"Institute for Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Elberling","sequence":"additional","affiliation":[{"name":"The Danish Multiple Sclerosis Registry Copenhagen University Hospital\u2014Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Koch\u2010Henriksen","sequence":"additional","affiliation":[{"name":"The Danish Multiple Sclerosis Registry Copenhagen University Hospital\u2014Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Epidemiology Aarhus University Hospital  Aarhus 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