Analysis of healthcare utilization before the diagnosis of radiologically isolated syndrome
Christine Lebrun‐Frénay, Sandrine Kerbrat, Darin T. Okuda, Cassandre Landes-Château, Orhun H. Kantarci, Chloé Pierret, Erwan Drézen, Emmanuel Nowak, Aksel Sıva, Christina Azevedo, Mikaël Cohen, Emmanuelle Leray
Abstract
Background: Previous studies have shown that people with multiple sclerosis (MS) had frequent healthcare visits up to 10 years before being diagnosed but with no information from magnetic resonance imaging (MRI) scans of the connection with the radiologically isolated syndrome (RIS). Objective: To analyze healthcare use 3 years before the RIS diagnosis. Methods: We examined healthcare usage before the first scan in RIS cases from 2010 to 2019. RIS subjects were identified from the French National MS observatory and compared to the general population (matched 10:1) and MS patients (matched 4:1). Results: Among 482 RIS individuals, 223 (46.3%) were not linked to the healthcare resources database. The remaining RIS individuals (53.7%) had higher healthcare usage before their RIS diagnosis for issues related to neurology visits, headaches (odds ratio (OR): 3.34, confidence interval (CI): [2.00–5.57], p < 0.0001), and the use of anti-migraine drugs (OR: 2.61, CI: [1.37–4.99], p = 0.004) compared to MS. Conclusion: Only about half of RIS patients had MS-selected healthcare resources, which allowed for data linkage. Those who did seek care before their RIS diagnosis were most commonly known for other neurological comorbidities. These findings do not support the idea of a systemic prodrome before RIS diagnosis.