Impact of comorbidities on the disability progression in multiple sclerosis

Marić, Gorica; Pekmezović, Tatjana; Tamaš, Olivera; Veselinović, N.; Jovanović, Aleksa; Lalić, Katarina; Mesaroš, Šarlota; Drulović, Jelena

doi:10.1111/ane.13516

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…Among 251 individuals with MS from Italy, a 1-point increase in the FRS was associated with an increased rate of reaching an EDSS score of 6 (HR 1.62; 1.22-3.01) ( 36 ). In a retrospective cohort of 2,725 individuals from Serbia, hypertension and diabetes were associated with a shorter time to reaching EDSS scores of 4, 6 and 7 ( 48 ). Uniquely, an Australian study examined the association between genetic polymorphisms associated with dyslipidemia and disability progression, allowing examination of the association between dyslipidemia and disability progression while limiting reverse causality ( 49 ).…”

Section: Effects Of Comorbiditiesmentioning

confidence: 99%

Etiology, effects and management of comorbidities in multiple sclerosis: recent advances

Marrie

Fisk

Fitzgerald³

et al. 2023

Front. Immunol.

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Comorbid conditions commonly affect people with multiple sclerosis (MS). Population-based studies indicate that people with MS have an increased incidence of ischemic heart disease, cerebrovascular disease, peripheral vascular disease, and psychiatric disorders as compared to people without MS. People with MS from underrepresented minority and immigrant groups have higher comorbidity burdens. Comorbidities exert effects throughout the disease course, from symptom onset through diagnosis to the end of life. At the individual level, comorbidity is associated with higher relapse rates, greater physical and cognitive impairments, lower health-related quality of life, and increased mortality. At the level of the health system and society, comorbidity is associated with increased health care utilization, costs and work impairment. A nascent literature suggests that MS affects outcomes from comorbidities. Comorbidity management needs to be integrated into MS care, and this would be facilitated by determining optimal models of care.

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Section: Effects Of Comorbiditiesmentioning

confidence: 99%

Etiology, effects and management of comorbidities in multiple sclerosis: recent advances

Marrie

Fisk

Fitzgerald³

et al. 2023

Front. Immunol.

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“…Another study has reported increased prevalence of hypertension and ischemic heart disease in traumatic spinal cord injured patients compared with their controls and increased prevalence of diabetes and ischemic heart disease in amputees 19 . Disability progression in patients with multiple sclerosis is also associated with cardiovascular disease comorbidities 20 . However, to the best of our knowledge, few studies have comprehensively examined associations between different types of disability and heart disease per se, especially in populations at risk of cardiovascular disease such as people with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Associations of disability with incidence of heart disease in people with diabetes

Kim,

Lee,

Shin

et al. 2024

Preprint

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This study investigated associations of disability, including its severity and type, with incidence of heart disease in people with diabetes. Korean National Health Insurance data from 2009 to 2019 were used. This study sampled 50% of people with disability registered in 2009 and 2010 and matched them 1:1 by sex and age to obtain a control group. A longitudinal analysis was conducted to examine the incidence of heart disease by disability, including its severity and type, in 17,338 diabetics from 2010 to 2019. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. Hazard ratio of disability for the incidence of heart disease in those with diabetes was statistically significantly increased in all adjusted models. By disability severity, it was higher in both mild and severe groups than in the non-disabled group. It was much higher in the severe group. By disability type, the hazard ratio for the incidence of heart disease was significantly increased in those with mobility, communication disability, and those classified as others, but not in those with a mental disability. In conclusion, disability was associated with an increased risk of developing heart disease among people with diabetes.

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“…Moreover, several studies observed that old age in MS is associated to a greater multimorbidity risk and, in turn, the presence of comorbidities, such as cardiovascular diseases, is considered a risk factor for disability accumulation (24,25). Age-associated comorbidities may also in uence the risk-bene t analysis for DMTs and be accompanied to reduced e cacy.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Ocrelizumab in Primary PrOgRessive mulTiple sclerosis: a mUlticeNter, retrospective, real-world sTudY (OPPORTUNITY)

Grazia

Bianco

Morra

et al. 2023

Preprint

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Ocrelizumab is a recombinant humanized monoclonal antibody selectively targeting CD20-expressing B cells. The effect of ocrelizumab on primary progressive multiple sclerosis (PPMS) has been evaluated during phase 3 trials that enrolled patients under 55 years with a maximum Expanded Disability Status Scale (EDSS) of 6.5. However, little is known on older disabled patients with longer of disease duration. We aimed to assess clinical effectiveness of ocrelizumab in PPMS patients out of the ORATORIO eligibility criteria. This multicenter retrospective study collected data about the effectiveness of ocrelizumab in PPMS patients who received treatment between May 2017 and June 2022 in the Italian MS centers contributing to the Italian MS Registry who adhered to compassionate use program. The confirmed EDSS worsening (CEW) (defined as either a ≤ 1-point or ≥ 2-points increase in EDSS score from baseline that was confirmed at T12 and T24) was calculated. At the date of data extraction, out of 887 PPMS patients who had received ocrelizumab, 589 (mean age 49.7±10.7 years, 242 [41.1%) females) were enrolled. The mean follow-up period was 41.3±12.3 months. A total of 149 (25.3%) received ocrelizumab according ORATORIO criteria (ORATORIO group) and 440 (74.7%) outside the ORATORIO criteria (non-ORATORIO group). No differences in terms of cumulative probabilities of 12- and 24-months of CEW of ≤1 point were found between ORATORIO and non-ORATORIO groups. Cox-regression analyses showed that age older than 65 years (HR 2.76, 25%CI 1.10–3.56; p = 0.01) was associated with higher risk of CEW at 24 months. Patients not responding to ORATORIO criteria for reimbursability may benefit from ocrelizumab treatment, thus suggesting to extend the possible use of this powerful agent in selected patients under the age of 65 years.

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Impact of comorbidities on the disability progression in multiple sclerosis

Cited by 13 publications

References 26 publications

Etiology, effects and management of comorbidities in multiple sclerosis: recent advances

Etiology, effects and management of comorbidities in multiple sclerosis: recent advances

Associations of disability with incidence of heart disease in people with diabetes

Effectiveness of Ocrelizumab in Primary PrOgRessive mulTiple sclerosis: a mUlticeNter, retrospective, real-world sTudY (OPPORTUNITY)

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