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In Brief | Neurology & Neurosurgery


A new study shows co-morbidities may increase risk of disease activity in multiple sclerosis patients 

Time to read: 01:26
Time to listen: 03:42
 
Published on MedED:  24 September 2024
Originally Published: 24 August 2024
Sourced: JAMA Neurology
Type of article: In Brief
MedED Catalogue Reference: MNIB002
Category: Neurology
Cross Reference: Psychiatry, Autoimmune Diseases
Keywords: multiple sclerosis, MS, psychiatry, co-morbidity, neurology

 

Key Takeaway
A higher burden of comorbidities is significantly associated with worse clinical outcomes in individuals with MS.
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Originally published in JAMA Neurology, 18 September 2024 This summary does not represent the original research, nor is it intended to replace the original research. Access the full Disclaimer Information

In this cohort study, researchers Salter & Lancia et al. used a meta-analytic approach to examine the association of comorbidities with disease activity in multiple sclerosis (MS).
 
Previous research has indicated that comorbidities worsen clinically relevant outcomes in MS patients, particularly regarding disability severity and progression. However, there has been limited exploration of the impact of comorbidities on disease activity metrics that are relevant to clinicians and clinical trialists, such as relapse rates and MRI lesion accrual.
 
Therefore, evidence of disease activity, or EDA, defined as confirmed relapse, disability worsening, or new lesions on MRI over a two-year follow-up period, was determined as the study's main outcome measurement.
 
The study analysed data from 16,794 participants enrolled in 17 phase 3 clinical trials of disease-modifying therapies (DMTs). 
 
Participants had various comorbidity burdens, including hypertension, hyperlipidaemia, cardiovascular diseases, diabetes, autoimmune conditions, migraines, lung and skin conditions, depression, anxiety, and other psychiatric disorders.
 
The following key findings were reported
 
• 61% of the pooled trial participants exhibited EDA over two years
 
• A higher comorbidity burden was associated with an increased hazard of EDA. Specifically:
• Having three or more comorbidities is associated with a 14% increased hazard of EDA. (Adjusted Hazard Ratio [AHR], 1.14; 95% CI, 1.02-1.28)
• Having two or more cardiometabolic conditions is associated with a 21% increased hazard of EDA. (AHR, 1.21; 95% CI, 1.08-1.37)
• Having one psychiatric disorder is associated with a 7% increased hazard of EDA.  (AHR, 1.07; 95% CI, 1.02-1.14)
 
These findings suggest that a higher burden of comorbidities is significantly associated with worse clinical outcomes in individuals with MS. However, the researchers allowed that comorbidity may be a partial mediator of negative prognostic factors. 
 
Nonetheless, based on the findings, the researchers conclude that there is sufficient evidence to suggest that addressing and managing comorbidities in patients with MS should be a critical clinical priority.
 
 
Access the original research article
 
 

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