Tettey, P and Siejka, D and Simpson Jr, S and Taylor, B and Blizzard, L and Ponsonby, A-L and Dwyer, T and van der Mei, I, Frequency of comorbidities and their association with clinical disability and relapse in Multiple Sclerosis, Neuroepidemiology, 46, (2) pp. 106-113. ISSN 0251-5350 (2016) [Refereed Article]
Copyright 2016 S. Karger AG, Basel
BACKGROUND: Multiple sclerosis (MS) patients may be at an increased risk of comorbidities due to the debilitating and chronic nature of the disease. An increased understanding of comorbidities and disease course in MS may provide new insights and enhance MS management. We aimed at investigating the frequency of comorbidities and their associations with clinical disability and relapse in MS.
METHODS: A prospective cohort of 198 MS patients was followed during 2002-2005 and queried about specific doctor-diagnosed comorbidities. In Australia, the MS cohort was compared to the 2007 general population with regard to the prevalence of comorbidities. Multilevel mixed-effects linear regression was used to assess the difference in subsequent disability between those who reported comorbidities and those who did not. The association of comorbidities with the hazard of relapse was assessed using survival analysis.
RESULTS: The age-standardised prevalence of hypertension, dyslipidaemia, asthma, psoriasis, eczema and anaemia was significantly higher in the MS cohort compared to that in the general Australian population. The level of disability (Multiple Sclerosis Severity Score) in those who reported overweight/obesity (β: 0.76 (95% CI 0.04-1.48), p = 0.037), or dyslipidaemia (β: 1.05 (95% CI 0.07-2.02), p = 0.036) was significantly higher compared to those who did not report these comorbidities, even after adjustment for potential confounders. There were no significant associations between comorbidities and change in disability. For relapse analyses, rheumatoid arthritis and anaemia were associated with more than threefold (hazard ratio, HR 3.70 (95% CI 1.80-7.58), p < 0.001) and twofold (HR 2.04 (95% CI 1.11-3.74), p = 0.022) increased risk of subsequent relapse respectively.
CONCLUSIONS: The prevalence of some comorbidities was higher in MS patients and associated with greater disability and relapse risk. Treatment of these comorbidities in patients with MS has the potential to improve disease course and help in the understanding of the prognosis and outcomes of MS.
|Item Type:||Refereed Article|
|Keywords:||Multiple sclerosis, Comorbidity, Epidemiological studies, Disability, Relapse, Prevalence|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Nervous System and Disorders|
|Author:||Tettey, P (Mr Prudence Tettey)|
|Author:||Siejka, D (Mr Dylan Siejka)|
|Author:||Simpson Jr, S (Dr Steve Simpson JR)|
|Author:||Taylor, B (Professor Bruce Taylor)|
|Author:||Blizzard, L (Professor Leigh Blizzard)|
|Author:||van der Mei, I (Associate Professor Ingrid van der Mei)|
|Web of Science® Times Cited:||10|
|Deposited By:||Menzies Institute for Medical Research|
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