Global and Regional Trends in Multiple Sclerosis Incidence with Projections to 2030: A Joinpoint Regression Analysis of the GBD Data 2021 by Socio‑Demographic Index and WHO Regions

Hamed Delam; Naeimehossadat Asmarian; Haleh Ghaem

doi:10.5334/aogh.5438

Global and Regional Trends in Multiple Sclerosis Incidence with Projections to 2030: A Joinpoint Regression Analysis of the GBD Data 2021 by Socio‑Demographic Index and WHO Regions

Annals of Global Health

Volume 92 (2026): Issue 1

By: Hamed Delam, Naeimehossadat Asmarian and Haleh Ghaem

Open Access

|Sep 2026

Filippi M, Bar‑Or A, Piehl F, et al. Multiple sclerosis. Nat Rev Dis Primers. 2018;4(1):43. doi:10.1038/s41572-018-0041-4.
Open DOI Search in Google Scholar Back to article
Karussis D. The diagnosis of multiple sclerosis and the various related demyelinating syndromes: A critical review. J Autoimmun. 2014;48–49:134–142. doi:10.1016/j.jaut.2014.01.022.
Open DOI Search in Google Scholar Back to article
Omidi A, Zolfaghari A, Mirab SM, et al. Mapping the complexity of multiple sclerosis: A novel perspective on genetic, environmental, and neurobiological insights. Mol Biol Rep. 2025;52(1):484. doi:10.1007/s11033-025-10572-6.
Open DOI Search in Google Scholar Back to article
Kapica‑Topczewska K, Kułakowska A, Kochanowicz J, Brola W. Epidemiology of multiple sclerosis: Global trends, regional differences, and clinical implications. Neurol Neurochir Pol. 2025;59(4):375–384. doi:10.5603/pjnns.103955.
Open DOI Search in Google Scholar Back to article
Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020;26(14):1816–1821. doi:10.1177/1352458520970841.
Open DOI Search in Google Scholar Back to article
Khan G, Hashim MJ. Epidemiology of multiple sclerosis: Global, regional, national and sub‑national‑level estimates and future projections. J Epidemiol Glob Health. 2025;15(1):21. doi:10.1007/s44197-025-00353-6.
Open DOI Search in Google Scholar Back to article
Forouhari A, Taheri G, Salari M, Moosazadeh M, Etemadifar M. Multiple sclerosis epidemiology in Asia and Oceania: A systematic review and meta‑analysis. Mult Scler Relat Disord. 2021;54:103119. doi:10.1016/j.msard.2021.103119.
Open DOI Search in Google Scholar Back to article
Jia D, Zhang Y, Yang C. The incidence and prevalence, diagnosis, and treatment of multiple sclerosis in China: A narrative review. Neurol Sci. 2022;43(8):4695–4700. doi:10.1007/s10072-022-06126-4.
Open DOI Search in Google Scholar Back to article
Zhang C, Liu W, Wang L, et al. Prevalence and burden of multiple sclerosis in China, 1990–2019: Findings from the Global Burden of Disease Study 2019. Neurology. 2024;102(11):e209351. doi:10.1212/wnl.0000000000209351.
Open DOI Search in Google Scholar Back to article
Kingwell E, Marriott JJ, Jetté N, et al. Incidence and prevalence of multiple sclerosis in Europe: A systematic review. BMC Neurol. 2013;13:128. doi:10.1186/1471-2377-13-128.
Open DOI Search in Google Scholar Back to article
García López FJ, García‑Merino A, Alcalde‑Cabero E, de Pedro‑Cuesta J. Incidence and prevalence of multiple sclerosis in Spain: A systematic review. Neurologia. 2024;39(8):639–650. doi:10.1016/j.nrleng.2022.02.004.
Open DOI Search in Google Scholar Back to article
Bose G, Thebault SDX, Atkins HL, Freedman MS. Does resetting the immune system fix multiple sclerosis? Can J Neurol Sci. 2020;47(1):1–10. doi:10.1017/cjn.2019.294.
Open DOI Search in Google Scholar Back to article
Paz‑Zulueta M, Parás‑Bravo P, Cantarero‑Prieto D, Blázquez‑Fernández C, Oterino‑Durán A. A literature review of cost‑of‑illness studies on the economic burden of multiple sclerosis. Mult Scler Relat Disord. 2020;43:102162. doi:10.1016/j.msard.2020.102162.
Open DOI Search in Google Scholar Back to article
Ponzio M, Santoni L, Molina M, Tavazzi E, Bergamaschi R. Economic burden of multiple sclerosis in an Italian cohort of patients on disease‑modifying therapy: Analysis of disease cost and its components. J Neurol. 2024;272(1):50. doi:10.1007/s00415-024-12729-y.
Open DOI Search in Google Scholar Back to article
Institute for Health Metrics and Evaluation (IHME). GBD Results Tool. University of Washington; 2021. https://ghdx.healthdata.org/gbd-2021.
Search in Google Scholar Back to article
Maleki Z, Hassanzadeh J, Aryaie M, Ghaem H. Global trend and geographic distribution of thyroid cancer from 1990 to 2021 and its prediction until 2030. Discov Oncol. 2025;16(1):2034. doi:10.1007/s12672-025-03766-8.
Open DOI Search in Google Scholar Back to article
Hyndman RJ, Koehler AB. Another look at measures of forecast accuracy. Int J Forecast. 2006;22(4):679–688. doi:10.1016/j.ijforecast.2006.03.001.
Open DOI Search in Google Scholar Back to article
Chai T, Draxler RR. Root mean square error (RMSE) or mean absolute error (MAE)?–Arguments against avoiding RMSE in the literature. Geosci Model Dev. 2014;7(3):1247–1250. doi:10.5194/gmd-7-1247-2014.
Open DOI Search in Google Scholar Back to article
Pianosi F, Beven K, Freer J, et al. Sensitivity analysis of environmental models: A systematic review with practical workflow. Environ Model Softw. 2016;79:214–232. doi:10.1016/j.envsoft.2016.02.008.
Open DOI Search in Google Scholar Back to article
Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335–351. doi:10.1002/(SICI)1097-0258(20000215)19:3<;335::AID-SIM336>3.0.CO;2-Z.
Open DOI Search in Google Scholar Back to article
Clegg LX, Hankey BF, Tiwari R, Feuer EJ, Edwards BK. Estimating average annual per cent change in trend analysis. Stat Med. 2009;28(29):3670–3682. doi:10.1002/sim.3733.
Open DOI Search in Google Scholar Back to article
Irimata KE, Bastian BA, Clarke TC, Curtin SC, Badwe R, Rui P. Guidance for selecting model options in the national cancer institute joinpoint regression software. Vital Health Stat 1. 2022;11:1–22.
Search in Google Scholar Back to article
Liu J, Fan H, Wang H, et al. Systematic study and 30‑year projections of global and multi‑regional burden of multiple sclerosis, 1990–2021. Medicine. 2025;104(44):e45089. doi:10.1097/md.0000000000045089.
Open DOI Search in Google Scholar Back to article
Moghaddam VK, Dickerson AS, Bazrafshan E, et al. Socioeconomic determinants of global distribution of multiple sclerosis: An ecological investigation based on Global Burden of Disease data. BMC Neurol. 2021;21(1):145. doi:10.1186/s12883-021-02170-3.
Open DOI Search in Google Scholar Back to article
Zhao P, Guan C, Lu J, et al. Global, regional, and national trends and burden of multiple sclerosis in adolescents and young adults: A data analysis from 1990 to 2021 and projections to 2040. Front Immunol. 2025;16:1685316. doi:10.3389/fimmu.2025.1685316.
Open DOI Search in Google Scholar Back to article
Lam T, VoPham T, Munger KL, Laden F, Hart JE. Long‑term effects of latitude, ambient temperature, and ultraviolet radiation on the incidence of multiple sclerosis in two cohorts of US women. Environ Epidemiol. 2020;4(4):e0105. doi:10.1097/ee9.0000000000000105.
Open DOI Search in Google Scholar Back to article
Simpson S, Wang W, Otahal P, et al. Latitude continues to be significantly associated with the prevalence of multiple sclerosis: An updated meta‑analysis. J Neurol Neurosurg Psychiatry. 2019;90(11):1193–1200. doi:10.1136/jnnp-2018-320189.
Open DOI Search in Google Scholar Back to article
Hwang S, Garcia‑Dominguez MA, Fitzgerald KC, Saylor DR. Association of multiple sclerosis prevalence with sociodemographic, health systems, and lifestyle factors on a national and regional level. Neurology. 2022;99(16):e1813–e1823. doi:10.1212/wnl.0000000000200962.
Open DOI Search in Google Scholar Back to article
Lane J, Ng HS, Poyser C, Lucas RM, Tremlett H. Multiple sclerosis incidence: A systematic review of change over time by geographical region. Mult Scler Relat Disord. 2022;63:103932. doi:10.1016/j.msard.2022.103932.
Open DOI Search in Google Scholar Back to article
Aderinto N, Olatunji G, Kokori E, et al. Prevalence, characteristics, and treatment outcome of multiple sclerosis in Africa: A systematic review. Discov Med. 2025;2(1):93. doi:10.1007/s44337-025-00294-w.
Open DOI Search in Google Scholar Back to article
Koh MJ, Saffari SE, Tye JSN, et al. A comparison of multiple sclerosis disease characteristics across three genetically diverse Asian racial groups in Singapore. Sci Rep. 2024;14(1):14690. doi:10.1038/s41598-024-65575-3.
Open DOI Search in Google Scholar Back to article
Kearns PKA, Paton M, O’Neill M, et al. Regional variation in the incidence rate and sex ratio of multiple sclerosis in Scotland 2010–2017: Findings from the Scottish Multiple Sclerosis Register. J Neurol. 2019;266(10):2376–2386. doi:10.1007/s00415-019-09413-x.
Open DOI Search in Google Scholar Back to article
Kułakowska A, Bartosik‑Psujek H, Hożejowski R, Mitosek‑Szewczyk K, Drozdowski W, Stelmasiak Z. Selected aspects of the epidemiology of multiple sclerosis in Poland ‑ a multicentre pilot study. Neurol Neurochir Pol. 2010;44(5):443–452. doi:10.1016/s0028-3843(14)60134-1.
Open DOI Search in Google Scholar Back to article
Pagalilauan AM, Everest E, Rachimi S, et al. The Canadian collaborative project on genetic susceptibility to multiple sclerosis cohort population structure and disease etiology. Front Neurol. 2025;16:1509371. doi:10.3389/fneur.2025.1509371.
Open DOI Search in Google Scholar Back to article
Houzen H, Kano T, Kondo K, Takahashi T, Niino M. The prevalence and incidence of multiple sclerosis over the past 20 years in northern Japan. Mult Scler Relat Disord. 2023;73:104696. doi:10.1016/j.msard.2023.104696.
Open DOI Search in Google Scholar Back to article
Buxhoeveden S, Swift‑Scanlan T, Goldman MD, Canissario R, Oh U. Exploring sex‑based mechanisms of inflammation and neurodegeneration in multiple sclerosis. Biol Res Nurs. 2026;28(2):283–295. doi:10.1177/10998004251387318.
Open DOI Search in Google Scholar Back to article
Coyle PK. Impact of sex on multiple sclerosis therapy. Neurotherapeutics. 2025;22(4):e00620. doi:10.1016/j.neurot.2025.e00620.
Open DOI Search in Google Scholar Back to article
Leffler J, Trend S, Gorman S, Hart PH. Sex‑specific environmental impacts on initiation and progression of multiple sclerosis. Front Neurol. 2022;13:835162. doi:10.3389/fneur.2022.835162.
Open DOI Search in Google Scholar Back to article
Maunula A, Laakso SM, Viitala M, Soilu‑Hänninen M, Sumelahti ML, Atula S. Incidence and prevalence of multiple sclerosis during eras of evolving diagnostic criteria‑a nationwide population‑based registry study over five decades. Mult Scler J Exp Transl Clin. 2025;11(1):20552173251326173. doi:10.1177/20552173251326173.
Open DOI Search in Google Scholar Back to article
Portaccio E, Magyari M, Havrdova EK, et al. Multiple sclerosis: Emerging epidemiological trends and redefining the clinical course. Lancet Reg Health Eur. 2024;44:100977. doi:10.1016/j.lanepe.2024.100977.
Open DOI Search in Google Scholar Back to article
de Menezes FTL, Alencar JMD, Lopes AB, et al. The impact of changing diagnostic criteria on disability in a Brazilian multiple sclerosis cohort. Arq Neuropsiquiatr. 2025;83(6):1–9. doi:10.1055/s-0045-1809662.
Open DOI Search in Google Scholar Back to article
Agrawal M, Sridhar S, Surendran AK, Bhatt A, Sriwastava S. Diagnostic evolution in multiple sclerosis: A narrative review of the McDonald criteria from 2001 to 2024. Mult Scler Relat Disord. 2025;106756. doi:10.1016/j.msard.2025.106756.
Open DOI Search in Google Scholar Back to article
Maunula A, Laakso SM, Viitala M, Soilu‑Hänninen M, Sumelahti ML, Atula S. Incidence and prevalence of multiple sclerosis during eras of evolving diagnostic criteria—a nationwide population‑based registry study over five decades. Mult Scler J Exp Transl Clin. 2025;11(1):20552173251326173. doi:10.1177/20552173251326173.
Open DOI Search in Google Scholar Back to article
Ferrand M, Epstein J, Soudant M, et al. Real‑life evaluation of the 2017 McDonald criteria for relapsing–remitting multiple sclerosis after a clinically isolated syndrome confirms a gain in time‑to‑diagnosis. J Neurol. 2024;271(1):125–133. doi:10.1007/s00415-023-11905-w.
Open DOI Search in Google Scholar Back to article
Xu C, Zhou T, Huang W. Response to letter regarding: Incidence, mortality, and DALYs of global pharyngeal cancer: Systematic analysis and projections based on global burden of disease study 2021. Ann Med. 2025;57(1):2564294. doi:10.1080/07853890.2025.2564294.
Open DOI Search in Google Scholar Back to article
Huang M, Zhaoli M, Xiu L, Qian R. Epidemiological burden assessment of six major immune‑mediated inflammatory diseases based on the Global Burden of Disease Study 2021: Analyses of age‑standardized incidence, prevalence, mortality, and disability‑adjusted life years. J Transl Autoimmun. 2025;11:100330. doi:10.1016/j.jtauto.2025.100330.
Open DOI Search in Google Scholar Back to article
Lu X, Borgonovo E. Global sensitivity analysis in epidemiological modeling. Eur J Oper Res. 2023;304(1):9–24. doi:10.1016/j.ejor.2021.11.018.
Open DOI Search in Google Scholar Back to article
GBD 2021 Forecasting Collaborators. Burden of disease scenarios for 204 countries and territories, 2022–2050: A forecasting analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2204–2256. doi:10.1016/s0140-6736(24)00932-2.
Open DOI Search in Google Scholar Back to article
Gómez‑Figueroa E, Moreno‑Bernardino CJ, De Alba‑Sánchez AM, et al. The burden of multiple sclerosis in Mexico. Neurology. 2025;104(5):e213343. doi:10.1212/wnl.0000000000213343.
Open DOI Search in Google Scholar Back to article

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.5334/aogh.5438 | Journal eISSN: 2214-9996

Journal RSS Feed

Language: English

Page range: 92 - 92

Submitted on: Jul 3, 2026

Accepted on: Aug 11, 2026

Published on: Sep 8, 2026

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Keywords:

multiple sclerosis,

incidence,

forecasting,

global burden of disease,

epidemiology

© 2026 Hamed Delam, Naeimehossadat Asmarian, Haleh Ghaem, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 92 (2026): Issue 1