Recombinant hepatitis B vaccine and the risk of multiple sclerosis

@article{Hernn2004RecombinantHB,
  title={Recombinant hepatitis B vaccine and the risk of multiple sclerosis},
  author={Miguel A. Hern{\'a}n and Susan S. Jick and Michael J. Olek and Hershel Jick},
  journal={Neurology},
  year={2004},
  volume={63},
  pages={838 - 842}
}
Background: A potential link between the recombinant hepatitis B vaccine and an increased risk of multiple sclerosis (MS) has been evaluated in several studies, but some of them have substantial methodologic limitations. Methods: The authors conducted a nested case-control study within the General Practice Research Database (GPRD) in the United Kingdom. The authors identified patients who had a first MS diagnosis recorded in the GPRD between January 1993 and December 2000. Cases were patients… 

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References

SHOWING 1-10 OF 33 REFERENCES
Hepatitis B vaccination and the risk of multiple sclerosis.
TLDR
A nested case-control study in two large cohorts of nurses in the United States indicates no association between hepatitis B vaccination and the development of multiple sclerosis.
Hepatitis B Vaccination and First Central Nervous System Demyelinating Event: A Case-Control Study
TLDR
This study was sufficiently powerful to rule out a strong association between HB vaccine exposure and a subsequent demyelinating event, however, it could not provide a clear indication of a moderately increased risk of a CNS demyELinating event shortly after HB vaccination in adults.
Hepatitis B vaccine and first episodes of central nervous system demyelinating disorders: a comparison between reported and expected number of cases.
TLDR
The results of this study do not provide strong arguments for ruling out the possibility of an association, causal or otherwise, between HB vaccine and first episode of central nervous system demyelinating disorders, and the underreporting coefficient is not significantly different from that expected at the 5% level.
Vaccinations and risk of central nervous system demyelinating diseases in adults.
TLDR
Vaccination against hepatitis B, influenza, tetanus, measles, or rubella is not associated with an increased risk of multiple sclerosis or optic neuritis.
The epidemiology of multiple sclerosis: A general overview
  • C. Poser
  • Medicine, Psychology
    Annals of neurology
  • 1994
TLDR
The concept of onset‐adjusted prevalence suggests that patients who are symptomatic should be included retrospectively in epidemiological surveys, even before they have been formally diagnosed as having MS, but individuals who were symptomatic before moving to a study area should not.
Drug abuse as a risk factor of multiple sclerosis: case-control analysis and a study of heterogeneity.
TLDR
Three main groups of MS subjects were obtained from the cluster analysis, distinguished by the gender, the presence or not of family history and the degree of severity of their physical disability, showing that drug abuse was the only risk factor with a statistically significant odds ratio for overall and for the unique female group without familial history of MS.
Audit of hepatitis B immunization at the genitourinary medicine department in Middlesbrough, UK
The outcomes of hepatitis B immunization programme at the genitourinary medicine (GUM) department in Middlesbrough during a period of five years were examined. The majority of those immunized were
New diagnostic criteria for multiple sclerosis: Guidelines for research protocols
TLDR
Today there is a need for more exact criteria than existed earlier in order to conduct therapeutic trials in multicenter programs, to compare epidemiological surveys, to evaluate new diagnostic procedures, and to estimate the activity of the disease process in MS.
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis
TLDR
The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic” disease suggestive of MS, disease with a typical relapsing‐remitting course, and disease with insidious progression, without clear attacks and remissions.
Use of the UK General Practice Research Database for pharmacoepidemiology.
TLDR
The General Practice Research Database in the UK has proved that valuable data can be collected in a general practice setting and should serve to encourage others to develop similar population-based data in other countries.
...
...