Multiple System Atrophy (MSA) Epidemiology

Key Highlights

• DelveInsight's analyst projects that in 2023, there were approximately 11 thousand diagnosed prevalent cases of MSA in the EU4 and the UK. This number is expected to grow at a compound annual growth rate (CAGR) of 0.6%, reaching a significant value by 2034.
• The increase in MSA cases is anticipated due to an aging population, advancements in diagnostic techniques, and greater awareness, resulting in earlier identification and a higher number of reported cases in 7MM.
• In 2023, the US had around 42 thousand cases of MSA, with cases projected to grow at a 1% CAGR by 2034.
• In 2023, Germany reported approximately 1.2 thousand cases of MSA in males and 1.5 thousand cases in females of MSA.
• In 2023, EU4 and the UK recorded around 8.8 thousand cases of symptomatic nOH in MSA patients, with projections indicating a substantial increase by 2034.
• In 2023, Japan reported the highest number of MSA cases among individuals aged 70 and above, with approximately 8.5 thousand cases, followed by the 60–69 and 50–59 age groups.

DelveInsight’s “MSA – Epidemiology Forecast – 2034” report delivers an in-depth understanding of MSA, historical and forecasted epidemiology of MSA in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2021-2034

Multiple System Atrophy (MSA) Disease Understanding 

Multiple System Atrophy (MSA) Overview

MSA is a progressive neurodegenerative disease presenting a mix of symptoms affecting movement and the autonomic nervous system.  

The exact cause of MSA remains unclear, with most cases occurring sporadically. A defining feature of the condition is the accumulation of alpha-synuclein, primarily in oligodendroglial cells, which are crucial for producing myelin—a protective layer that facilitates nerve signal transmission.  

Currently, there is no conclusive evidence connecting environmental factors, such as chemicals in food, air, or water, to an increased risk of MSA. It is widely believed that a combination of genetic predisposition and environmental influences contributes to the disease's onset and progression.

Early symptoms of MSA include bradykinesia, tremors, stiffness, and poor coordination. The disorder is categorized into two main subtypes: MSA-P, characterized by Parkinsonian features resembling Parkinson’s disease, and MSA-C, marked by cerebellar dysfunction, such as ataxia and balance issues. These subtypes reflect the varied neurological effects of MSA, a progressive condition. However, the classifications are not rigid, as patients may experience a shift in symptoms between the two subtypes over time. This variability highlights the complexity of MSA and its impact on both movement and coordination as the disease progresses.

Diagnosing of MSA is challenging, especially in its early stages, as its symptoms often overlap with those of Parkinson’s disease. This similarity can make it difficult to distinguish between the two conditions. To aid in diagnosis, various tests may be conducted. Autonomic testing, which evaluates functions such as blood pressure regulation and heart rate control, is commonly used. Bladder function assessments are another diagnostic tool, as urinary issues are frequently associated with MSA. Additionally, neuroimaging techniques like MRI or PET scans can provide valuable insights, helping to identify structural or functional brain changes indicative of MSA. These diagnostic methods, while helpful, are not definitive, and a combination of clinical evaluation and test results is typically required to confirm the diagnosis. The complexity of diagnosing MSA underscores the need for thorough medical assessment and specialized expertise in distinguishing it from other neurodegenerative disorders.

Further details related to diagnosis are provided in the report…

Multiple System Atrophy Epidemiology

For the purpose of designing the patient-based model for MSA, the report provides historical as well as forecasted epidemiology segmented by Diagnosed Prevalent Cases of MSA, Gender-specific Diagnosed Prevalent Cases of MSA, Age-specific Diagnosed Prevalent Cases of MSA, Type-specific Diagnosed Prevalent Cases of MSA, Stage-specific Diagnosed Prevalent Cases of MSA, and nOH Symptomatic Cases of MSA in the 7MM covering the United States, EU4 countries (Germany, France, Italy, and Spain), the United Kingdom, and Japan, from 2021 to 2034. 

• DelveInsight's epidemiology model estimates that in 2023, there were approximately 70 thousand diagnosed prevalent cases of MSA across the 7MM which are expected to increase by 2034.
• In 2023, the US reported the highest number of diagnosed prevalent cases of MSA among the 7MM, with approximately 42 thousand, a figure expected to rise by 2034.
• In 2023, Germany reported the highest number of MSA cases in individuals aged 70+ years, with approximately 1.4 thousand cases, surpassing those in the 50–59 and 60–69 age groups. 
• In 2023, 48% of MSA cases in the United States were male, while females accounted for 52%. These gender-specific trends are expected to continue, with the number of cases projected to increase further by 2034.
• In 2023, Japan reported nearly 13 thousand cases of nOH symptomatic MSA.
• In France, the stage-specific diagnosed prevalent cases of MSA in 2023 were approximately 20 in Stage 0, ~40 in Stage 1, ~100 in Stage 2, ~800 in Stage 3, ~700 in Stage 4, and ~500 in Stage 5, with these figures expected to increase by 2034.
• In Spain, around 58% of MSA cases in 2023 were attributed to MSA-P, while 42% were linked to MSA-C.
• In 2023, the UK reported around 1.9 thousand cases of nOH symptomatic MSA and these numbers are expected to increase by 2034.
• In 2023, Italy reported approximately 1,200 diagnosed prevalent cases of MSA in males and nearly 960 cases in females, with numbers projected to rise by 2034.

KOL Views

To gaze into the epidemiology insights of the real world, we take KOLs and SMEs’ opinions working in the domain through primary research to fill the data gaps and validate our secondary research on disease prevalence. 

DelveInsight’s analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as the University of California, the US, University of Maryland School of Medicine, the US, University of Texas Southwestern, the US, University Medical Center, Johannes-Gutenberg-University, Germany, Department of Neurology Center Hospitalier de la Côte Basque Bayonne, France, University of Pisa, Italy, Barcelona Clinical Hospital, Spain, University of Aberdeen, the UK, Hyogo College of Medicine, Japan, among others were contacted. Their opinion helps understand and validate current disease prevalence, gender involved with the disease, diagnosis rate, and diagnostic criteria.

As per the KOLs from the US, the diagnosis of MSA relies on a combination of clinical evaluation, neurological examination, and exclusion of other conditions. Key diagnostic criteria include autonomic dysfunction, motor impairments such as Parkinsonism or cerebellar ataxia, and supporting imaging findings like brain atrophy or signal changes on MRI.

As per the KOLs from the Germany, the MSA distinction into MSA-P and MSA-C is based on the predominant clinical features. MSA-P is more common in most of the countries, with the exception of Japan, where MSA-C is the predominant phenotype.

As per the KOLs from Japan, the prognosis of MSA is generally worse than that of hereditary ataxia or Parkinson’s disease. Identifying the time from the first symptom to the development of multiple system impairments is critical for accurate diagnosis, patient counseling, and designing effective clinical trials.

Scope of the Report

• The report covers a segment of key events, an executive summary, a descriptive overview of MSA, explaining its causes, signs and symptoms, and currently available diagnostic algorithms and guidelines.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and diagnosis guidelines.
• The report provides an edge for understanding trends, expert insights/KOL views, and patient journeys in the 7MM.
• A detailed review of current challenges in establishing the diagnosis.

Multiple System Atrophy Report Insights

• Patient Population
• Country-wise Epidemiology Distribution
• Diagnosed Prevalent Cases of MSA 
• Gender-specific Diagnosed Prevalent Cases of MSA 
• Age-specific Diagnosed Prevalent Cases of MSA 
• Type-specific Diagnosed Prevalent Cases of MSA 
• Stage-specific Diagnosed Prevalent Cases of MSA
• nOH Symptomatic Cases of MSA

Multiple System Atrophy Report Key Strengths

• 10 years Forecast
• The 7MM Coverage 
• MSA Epidemiology Segmentation 
• Multiple System Atrophy Report Assessment
• Current Diagnostic Practices Patient Segmentation

Epidemiology Insights

• What are the disease risks, burdens, and unmet needs of MSA? What will be the growth opportunities across the 7MM concerning the patient population of MSA?
• What is the historical and forecasted MSA patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Why are the total cases of MSA in Japan lower than in the US?
• Which country has a high patient share for MSA?

Reasons to Buy

• Insights on patient burden/disease, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the MSA cases in varying geographies over the coming years.
• To understand the perspective of key opinion leaders around the current challenges with establishing the diagnosis options.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges. 

Frequently Asked Questions

1. What is the forecast period covered in the report?

The MSA Epidemiology Forecast report for the 7MM covers the forecast period from 2025 to 2034, providing a projection of epidemiology dynamics and trends during this timeframe.

2. Out of all EU4 countries and the UK, which country had the highest population of MSA cases in 2023?

The highest cases of MSA were found in Germany among EU4 and the UK in 2023.

3. How is epidemiological data collected and analyzed for forecasting purposes?

Epidemiological data is collected through surveys, clinical studies, health records, and other sources. It is then analyzed to calculate disease rates, identify trends, and project future disease burdens using mathematical models.

4. Out of all 7MM countries, which country had the highest population of MSA cases in 2023?

The highest cases of MSA were found in the US among the 7MM in 2023.