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Mortality and comorbidities in patients with multiple sclerosis compared with a population without multiple
Gorana Capkun1, Frank Dahlke1, Raquel Lahoz1
1Novartis Pharma AG, Basel, Switzerland.
Background:
Data are limited for mortality and comorbidities in patients with multiple sclerosis (MS).
Objectives:
Compare mortality rates and event rates for comorbidities in MS (n=15,684) and non-MS (n=78,420) cohorts from the US Department of Defense (DoD) database.
Methods:
Comorbidities and all-cause mortality were assessed using the database. Causes of death (CoDs) were assessed through linkage with the National Death Index. Cohorts were compared using mortality (MRR) and event (ERR) rate ratios.
Results:
All-cause mortality was 2.9-fold higher in the MS versus non-MS cohort (MRR, 95% confidence interval [CI]: 2.9, 2.7-3.2). Frequent CoDs in the MS versus non-MS cohort were infectious diseases (6.2, 4.2-9.4), diseases of the nervous (5.8, 3.7-9.0), respiratory (5.0, 3.9-6.4) and circulatory (2.1, 1.7-2.7) systems and suicide (2.6, 1.3-5.2). Comorbidities including sepsis (ERR, 95% CI: 5.7, 5.1-6.3), ischemic stroke (3.8, 3.5-4.2), attempted suicide (2.4, 1.3-4.5) and ulcerative colitis (2.0, 1.7-2.3), were higher in the MS versus non-MS cohort. The rate of cancers was also higher in the MS versus the non-MS cohort, including lymphoproliferative disorders (2.2, 1.9-2.6) and melanoma (1.7, 1.4-2.0).
Conclusions:
Rates of mortality and several comorbidities are higher in the MS versus non-MS cohort. Early recognition and management of comorbidities may reduce premature mortality and improve quality of life in patients with MS.
Insights
Patients with multiple sclerosis (MS) face significantly higher mortality rates and increased risks of various comorbidities, including infections and cancers. Early management of these conditions is crucial for improving outcomes in MS patients.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Limited data exist on mortality and comorbidity prevalence in multiple sclerosis (MS) patients.
- Understanding these risks is crucial for patient care and resource allocation.
Purpose of the Study:
- To compare mortality rates and comorbidity event rates between patients with MS and a non-MS cohort.
- Utilized data from the US Department of Defense (DoD) database for a large-scale comparison.
Main Methods:
- Compared mortality and comorbidity data from 15,684 MS patients against 78,420 non-MS individuals.
- Assessed all-cause mortality and specific comorbidities using DoD database records.
- Linked data with the National Death Index to determine causes of death.
Main Results:
- All-cause mortality was 2.9 times higher in the MS cohort compared to the non-MS cohort.
- MS patients exhibited elevated rates of infectious diseases, nervous system disorders, respiratory diseases, circulatory diseases, and suicide.
- Increased comorbidity rates in MS included sepsis, ischemic stroke, attempted suicide, ulcerative colitis, lymphoproliferative disorders, and melanoma.
Conclusions:
- Multiple sclerosis is associated with significantly higher mortality and comorbidity rates.
- Prompt identification and management of comorbidities in MS patients can potentially reduce premature death and enhance quality of life.