Kyla Anne Mckay

Multiple sclerosis (MS) and related immune-mediated inflammatory disorders (IMIDs) are common. Globally, nearly 1 in 25 people live with at least one IMID. MS affects over 90,000 people in Canada. Similar to MS, IMIDs are often lifelong, which lowers a person's quality of life substantially. To prevent this, identifying what can help prevent IMIDs or improve their clinical management is essential. Many diseases have early warning signs called a prodrome. These early signs occur before the clinical symptoms of the disease and its formal diagnosis. Hence, a prodromal sign may help identify when or if the disease has started. However, a challenge is that these early warning signs may be vague, making it hard to tell what disease the signs point to. To overcome this challenge and facilitate early diagnosis, we need to identify disease-specific prodromal signs. A novel way is by contrasting the prodromal phases of MS to other IMIDs. Understanding how signs in these conditions are the same or different can help develop targeted interventions such as better diagnosis criteria. We would also look at how these prodromal features impact delay in starting MS-specific treatments. We will use routinely collected healthcare information, such as the number and reasons for doctor and hospital visits. These data are anonymized and available to researchers following strict privacy and ethical rules. We will access these data from Sweden and Canada (British Columbia and Ontario) and identify people with MS, five other IMIDs, their full siblings, and people of the same age and sex without any of these diseases. We will see whether MS and other IMIDs that are genetically similar to MS also show similarities in healthcare use and types of symptoms during their prodromal phases. The knowledge generated in our research can be used to identify people at risk of these conditions early, helping with better and faster diagnosis and facilitating earlier treatment.

Multiple sclerosis (MS) is a chronic disabling disease of the brain and spinal cord with an unknown aetiology. In recent years, researchers have discovered a ‘prodromal’ period before MS onset (non-specific signs and symptoms up to five years prior) and heralded in a new era of disease-modifying treatment (DMT). These breakthroughs have led to further questions regarding the pre-clinical ‘at-risk’ period and how to best optimize treatment.Aims: For the first time, we aim to access highly granular clinical data from Region Stockholm to:Identify risk factors for the development of MS

Characterize the MS prodromal period

Evaluate the long-term risk of disease worsening as it relates to demographic and clinical characteristics and DMT use (precision medicine). Apply advanced modelling techniques to predict MS risk, prognosis, and treatment response.  The Region Stockholm data contains clinical details on an estimated 4000 persons who developed MS between 2001 and 2024, including primary and specialty care, imaging and lab results, pharmacy records, and free text in electronic health records. This will enable us to explore, longitudinally, both the pre-clinical period (in comparison to a reference cohort of 500,000 non-MS individuals in Stockholm) and clinical periods (through linkage with the MS Registry). This knowledge will facilitate an improved understanding of risk factors and the prodromal period, and guide long-term management of this chronic and costly disease.