Effect of autoimmune comorbidities on multiple sclerosis course: An observational multicenter study

Area of Science:

• Neurology
• Immunology
• Epidemiology

Background:

• Autoimmune comorbidities (AC) are frequently observed in people with multiple sclerosis (PwMS).
• Understanding the impact of AC on MS progression and treatment is crucial for patient management.
• Characterizing AC associated with MS can inform personalized therapeutic strategies.

Purpose of the Study:

• To investigate the age and disability at diagnosis in PwMS with and without AC.
• To evaluate the effect of AC on No Evidence of Disease Activity-3 (NEDA-3) status.
• To compare therapeutic approaches in MS patients with and without AC.

Main Methods:

• A population-based, multicentric study involving 873 patients with relapsing-remitting MS (RRMS).
• Patients were categorized into groups with (AC group) or without (reference group) AC.
• Data on demographics, clinical features, treatments, MRI activity, EDSS, and NEDA-3 status were collected at baseline and 36 months.

Main Results:

• 24.7% of RRMS patients had at least one AC.
• Patients with AC were diagnosed at an older age with higher disability scores (EDSS) compared to the reference group.
• The AC group showed a lower risk of losing NEDA-3 status and received different treatments (glatiramer acetate, natalizumab, rituximab) compared to the reference group (interferon-beta, fingolimod).

Conclusions:

• AC are common in PwMS and associated with delayed onset, diagnosis, and higher initial disability.
• The presence of AC in PwMS does not correlate with a poorer long-term prognosis.
• Tailored therapeutic strategies may be considered for MS patients with coexisting autoimmune conditions.