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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(12): s00451813263
DOI: 10.1055/s-0045-1813263
Original Article

Epidemiology and healthcare access in Brazilian multiple sclerosis patients: insights from the BRANDO database

Authors

  • Alfredo Damasceno 

    1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.

  • Cintia Ramari 

    2   University of Hasselt, Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt, Belgium.

  • Carlos Tauil 

    3   Universidade de Brasília, Brasília DF, Brazil.

  • Henry Koiti Sato 

    4   Instituto Neurológico de Curitiba, Departamento de Neuroimunologia, Curitiba PR, Brazil.

  • Dagoberto Callegaro 

    5   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.

  • Maria Fernanda Mendes 

    6   Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo SP, Brazil.

  • José Artur Costa D'Almeida 

    7   Hospital Geral de Fortaleza, Departamento de Neurologia, Fortaleza CE, Brazil.

  • Denise Sisterolli Diniz 

    8   Hospital Geral de Goiás, Departamento de Neurologia, Goiânia GO, Brazil.

  • Osvaldo J. M. Nascimento 

    9   Hospital Universitário Antônio Pedro, Departamento de Neurologia, Fortaleza CE, Brazil.

  • Laura Parolin 

    10   Neurovie Neurologia e Saúde, Departamento de Neurologia, Joinville SC, Brazil.

  • Thiago Fukuda 

    11   Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Departamento de Neurologia e Psiquiatria, Salvador BA, Brazil.
    12   Universidade do Estado da Bahia, Departamento de Ciências da Vida, Salvador BA, Brazil.

  • Paulo Gama 

    13   Pontifícia Universidade Católica de São Paulo, Faculdade de Ciências Médicas e da Saúde, Departamento de Neurologia, Sorocaba SP, Brazil.

  • Herval Soares Neto 

    14   Hospital do Servidor Estadual de São Paulo, Departamento de Neuroimunologia, São Paulo SP, Brazil.

  • Marco Lana-Peixoto 

    15   Universidade Federal de Minas Gerais, Centro de Investigação de Esclerose Múltipla, Belo Horizonte MG, Brazil.

  • Giordani Rodrigues dos Passos 

    16   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto Alegre RS, Brazil.

  • Rayllene Caetano 

    16   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto Alegre RS, Brazil.

  • Kleber Cavalcante Santos 

    17   Hospital das Forças Armadas, Brasília DF, Brazil.

  • Caio César Diniz Disserol 

    4   Instituto Neurológico de Curitiba, Departamento de Neuroimunologia, Curitiba PR, Brazil.
    18   Universidade Federal do Paraná, Hospital das Clínicas, Departamento de Neurologia, Curitiba PR, Brazil.

  • Gabriel de Deus Vieira 

    1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.

  • Guilherme Diogo Silva 

    5   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.

  • Eliana Cunha 

    6   Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo SP, Brazil.

  • Natália Talim 

    15   Universidade Federal de Minas Gerais, Centro de Investigação de Esclerose Múltipla, Belo Horizonte MG, Brazil.

  • Mario B. Wagner 

    19   Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Porto Alegre RS, Brazil.
    20   Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Porto Alegre RS, Brazil.

  • Milena Sales Pitombeira 

    7   Hospital Geral de Fortaleza, Departamento de Neurologia, Fortaleza CE, Brazil.

  • Jefferson Becker 

    16   Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto Alegre RS, Brazil.

Funding The authors declare that the present study was funded by the Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS).
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Abstract

Background

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder whose prevalence varies across Brazil (from 15–27 cases per 100 thousand inhabitants), and the absence of an extensive national study limits the understanding of MS epidemiology in a nation as diverse as Brazil.

Objective

To compare epidemiological data, including healthcare access, among people with MS across four Brazilian regions.

Methods

Data from 2,974 Brazilian MS patients in the Collaborative Latin American Database for Multiple Sclerosis (BRANDO) were analyzed. We assessed demographic and clinical outcomes, as well as healthcare access, to elucidate regional differences.

Results

The cohort was predominantly composed of female patients (72.5%) with MS onset at a mean age of 30.6 years. Regarding the regional differences, there was a lower predominance of female patients (68.7%; p = 0.003) in the Southeast, a higher rate of subjects of mixed ethnicity (p < 0.001) in the Midwest (40.3%) and Northeast (63.7%), higher scores on the Expanded Disability Status Scale (EDSS) in the Northeast (4.0; p < 0.001), a higher prevalence of relapsing-remitting MS (RRMS) in the Southeast and Midwest (87%; p < 0.001), while the Northeast presented (p < 0.001) the highest rates of primary progressive MS (PPMS) and secondary progressive MS (SPMS) (PPMS = 15.8%; SPMS = 18%). The Northeast presented the longest time (5.9 years; p < 0.01) from disease onset until MS diagnosis (range for the other regions = 1.9–3.7 years). And the Midwest showed the shortest time (2.1 years; p < 0.01) from disease onset until first access to disease-modifying therapies (DMTs; range for the other regions = 3.5–5.1 years).

Conclusion

The present is the first nationwide epidemiological study on people with MS in Brazil. It underscores regional epidemiological variations and differences in healthcare access, advocating for tailored approaches in MS management and research.

Keywords

Multiple Sclerosis - Latin America - Epidemiology - Health Inequities - Nervous System Diseases - Demography

Data Availability Statement

Data will be available upon request to the corresponding author.


Authors' Contributions

Conceptualization: AD, CR, JB; Data curation: MBW, CR; Formal analysis: MBW, CR; Funding acquisition: AD, CR, JB, NT; Investigation: AD, CT, HKS, DC, MFM, JACD, DSD, OJMN, LP, TF, PG, HSN, MLP, GRP, RC, KCS, CCDD, GDV, GDS, EC, MSP, JB; Methodology: AD, CR, JB, MSP; Project administration: CR, AD, JB; Resources: AD, CT, HKS, DC, MFM, JACD, DSD, OJMN, LP, TF, PG, HSN, MLP, GRP, RC, KCS, CCDD, GDV, GDS, EC, MSP, JB; Software: MBW; Supervision: AD, JB, MLP, DC, MSP; Visualization: CR; Writing - original draft: CR, AD; Writing - review & editing: AD, CR, JB, DC, MLP, MSP, MFM, GRP, OJMN, JACD, PG, GDS.


Editor-in-Chief: Hélio A. G. Teive (ORCID: 0000-0003-2305-1073).


Associate Editor: Douglas Kazutoshi Sato (ORCID: 0000-0002-7695-6020).


On behalf of the Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS).




Publication History

Received: 07 June 2025

Accepted: 23 September 2025

Article published online:
22 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Alfredo Damasceno, Cintia Ramari, Carlos Tauil, Henry Koiti Sato, Dagoberto Callegaro, Maria Fernanda Mendes, José Artur Costa D'Almeida, Denise Sisterolli Diniz, Osvaldo J. M. Nascimento, Laura Parolin, Thiago Fukuda, Paulo Gama, Herval Soares Neto, Marco Lana-Peixoto, Giordani Rodrigues dos Passos, Rayllene Caetano, Kleber Cavalcante Santos, Caio César Diniz Disserol, Gabriel de Deus Vieira, Guilherme Diogo Silva, Eliana Cunha, Natália Talim, Mario B. Wagner, Milena Sales Pitombeira, Jefferson Becker. Epidemiology and healthcare access in Brazilian multiple sclerosis patients: insights from the BRANDO database. Arq Neuropsiquiatr 2025; 83: s00451813263.
DOI: 10.1055/s-0045-1813263