{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:25:21Z","timestamp":1787397921271,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["01GI0914"],"award-info":[{"award-number":["01GI0914"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["01GI1601B"],"award-info":[{"award-number":["01GI1601B"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Understanding sex differences in relapsing\u2013remitting multiple sclerosis (RRMS) and initiation of disease-modifying treatments (DMTs) is crucial for tailored approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study is to analyze sex-specific differences in early RRMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data of therapy-na\u00efve adults from the German NationMS cohort to describe first symptoms, onset relapse treatment, disability evolution, and DMT exposure separated by sex to investigate previously described sex differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Relapse presentation and treatment were similar (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009n.s.). Time to Expanded Disability Status Scale (EDSS) \u2a7e3.0 was comparable between sexes (adjusted hazard ratio, 95% confidence interval (95% CI): 1.32 (0.95\u20131.81)). DMT exposure did not differ (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.60). Around 5.0% of both sexes received initial high-efficacy (HE) DMT. Younger age (odds ratio (OR) (95% CI): 0.95 (0.92\u20130.98);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.000847), higher baseline EDSS (1.79 (1.40\u20132.27);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.00000218), and RRMS diagnosis (2.26 (1.28\u20134.17),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006703) were associated with initial HE-DMT, but not sex (0.99 (0.57\u20131.77),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.943166).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We did not observe major sex differences in early MS as described earlier regarding initial presentation and disability evolution suggesting a change of MS course. The decision for initial HE-DMT was influenced by younger age and higher EDSS, but not sex suggesting a lower sex bias regarding the initial treatment decision, yet only investigated in specialized academic MS centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261446846","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:47:08Z","timestamp":1780336028000},"page":"839-851","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-specific analysis of early disease course and treatment in a German multiple sclerosis cohort"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4369-0633","authenticated-orcid":false,"given":"Philip Lennart","family":"Poser","sequence":"first","affiliation":[{"name":"Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gisevius","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Tokic","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0493-8656","authenticated-orcid":false,"given":"Anne Lena","family":"Fisse","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Ladopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Berthele","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Giglhuber","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Flaskamp","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinzenz","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2179-3655","authenticated-orcid":false,"given":"Stefan","family":"Bittner","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"L\u00fcssi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Bayas","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Augsburg, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven G","family":"Meuth","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty, Heinrich-Heine University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Heesen","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Trebst","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Wildemann","sequence":"additional","affiliation":[{"name":"Molecular Neuroimmunology Group, Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Then Bergh","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Leipzig, Leipzig, 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