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Published on: December 9, 2015
Association between comorbidity and clinical characteristics of MS
R A Marrie1, R I Horwitz, G Cutter
1Department of Medicine, University of Manitoba, Winnipeg, Canada. rmarrie@hsc.mb.ca
Background:
Comorbidity may be associated with the clinical phenotype of disease and may affect prognostication and treatment decisions. Using the North American Research Committee on Multiple Sclerosis Registry, we described comorbidities present at onset and diagnosis of multiple sclerosis (MS) and examined whether comorbidities present at onset were associated with clinical course or age of MS symptom onset.
Methods:
In 2006, 8983 participants reported their physical and mental comorbidities; smoking status; height; and past and present weight. We compared clinical course at onset and age of symptom onset by comorbidity status.
Results:
At MS onset, a substantial proportion of participants had physical (24%) or mental (8.4%) comorbidities. The mean (SD) age of MS onset was 31.2 (9.0) years. Vascular, autoimmune, cancer, visual, and musculoskeletal comorbidities were associated with a later age of symptom onset. Among men and women, the odds of a relapsing course at onset were increased if mental comorbidities (OR 1.48; 1.08-2.01) were present at symptom onset. In women, gastrointestinal comorbidities (OR 1.78; 1.25-2.52) and obesity (OR 2.08 1.53-2.82) at MS onset were also associated with a relapsing course at onset.
Conclusions:
Comorbidity is frequently present at onset of MS and is associated with differences in clinical characteristics.
Insights
Comorbidities are common at multiple sclerosis (MS) onset and impact disease course. Mental health conditions, gastrointestinal issues, and obesity are linked to a relapsing MS course.
Area of Science:
- Neurology
- Clinical Research
- Epidemiology
Background:
- Comorbidity influences disease presentation, prognosis, and treatment strategies.
- Understanding comorbidities at multiple sclerosis (MS) onset is crucial for patient management.
- The North American Research Committee on Multiple Sclerosis Registry provides a valuable dataset for this investigation.
Purpose of the Study:
- To describe the prevalence of physical and mental comorbidities at MS onset.
- To investigate the association between comorbidities at MS onset and the clinical course of MS.
- To examine the relationship between comorbidities at MS onset and the age of MS symptom onset.
Main Methods:
- Utilized data from 8983 participants in the North American Research Committee on Multiple Sclerosis Registry.
- Collected information on physical and mental comorbidities, smoking status, height, and weight.
- Compared clinical course and age of symptom onset based on comorbidity status.
Main Results:
- 24% of participants had physical comorbidities and 8.4% had mental comorbidities at MS onset.
- Vascular, autoimmune, cancer, visual, and musculoskeletal comorbidities were linked to a later age of MS symptom onset.
- Mental comorbidities increased the odds of a relapsing MS course (OR 1.48) in both sexes. In women, gastrointestinal comorbidities (OR 1.78) and obesity (OR 2.08) also increased the odds of a relapsing course.
Conclusions:
- Comorbidity is a frequent occurrence at the onset of multiple sclerosis.
- The presence of comorbidities at MS onset is associated with distinct clinical characteristics and disease trajectories.
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