Comorbidity in in patients with relapsing-remitting multiple sclerosis
DOI:
https://doi.org/10.26641/2307-0404.2024.3.313600Keywords:
comorbidity, relapsing-remitting multiple sclerosis, disability, concomitant diseasesAbstract
Multiple sclerosis is a chronic autoimmune inflammatory disease that affects the brain and spinal cord. The most common form of this disease according to the type of its course is relapsing-remitting multiple sclerosis. Comorbidity in multiple sclerosis is an urgent problem of modern neurology, since it can influence such factors as the time of diagnosis, the rate of disease progression and the rate of patient disability, the number of exacerbations and the patient’s quality of life. The purpose of the work was to study and characterize comorbidity in patients with relapsing multiple sclerosis. To conduct this study 105 patients with a diagnosis of relapsing-remitting multiple sclerosis were enrolled. All patients were assessed using the Multiple Sclerosis Neurological Disability Severity Scale (EDSS). Study participants were divided into two groups – Group 1 and Group 2 – based on EDSS scores. Separately, study participants were divided into groups based on the principle of receiving pain-modifying therapy. In the 1st study group, concomitant diseases were in 57 (78.1%) patients, in the 2nd group – in 100% (p=0.010). In patients who did not receive pain-modifying therapy, 57 (98.3%) of those examined had concomitant diseases, in those who received such treatment – in 32 (68.1%), which was statistically significantly less (p<0.001). In the first place in terms of the frequency of concomitant pathology among all examined patients were diseases of the gastrointestinal tract, which also dominated in the 1st and 2nd observation groups, in the second place – diseases of the urinary system, in the third place – eye diseases, and in the last place, by the frequency of concomitant diseases – cardiovascular diseases. Comorbidity in multiple sclerosis is an extremely relevant problem in modern neurology due to its significant impact on the clinical picture of the disease, its course and the degree of disability of the patient. Digestive system disease is one of the most common comorbid conditions in multiple sclerosis. The number of patients with comorbid conditions is higher among patients with a moderate degree of disability and among patients not taking disease-modifying therapy, but the relationship between the degree of disability, treatment and comorbid conditions requires further study.
References
Somilo OV, Makarov SO, Kalbus OI, Sorokin AV. [Anxiety and depression in patients with multiple sclerosis]. Medicni perspektivi. 2023;28(2):106-11. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2023.2.283349
Dobson R, Giovannoni G. Autoimmune disease in people with multiple sclerosis and their relatives: a systematic review and meta-analysis. J Neurol. 2013;260:1272-85. doi: https://doi.org/10.1007/s00415-012-6790-1
Gascoyne CR, Simpson S, Chen J, van der Mei I, Marck CH. Modifiable factors associated with depression and anxiety in multiple sclerosis. Acta Neurol Scand. 2019;140:204-11. doi: https://doi.org/10.1111/ane.13132
Ge F, Huo Z, Li C, et al. Lung cancer risk in patients with multiple sclerosis: a mendelian randomization analysis. Mult Scler Relat Disord. 2021;51:102927. doi: https://doi.org/10.1016/j.msard.2021.102927
Grytten N, Myhr KM, Celius EG, et al. Risk of cancer among multiple sclerosis patients, siblings, and population controls: a prospective cohort study. Mult Scler. 2020;26(12):1569-80. doi: https://doi.org/10.1177/1352458519877244
Kosmidou M, Katsanos AH, Katsanos KH, et al. Multiple sclerosis and inflammatory bowel diseases: a systematic review and meta-analysis. J Neurol. 2017;264:254-9. doi: https://doi.org/10.1007/s00415-016-8340-8
Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology. 1983;33(11):1444. doi: https://doi.org/10.1212/WNL.33.11.1444
Lo LMP, Taylor BV, Winzenberg T, et al. Estimating the relative contribution of comorbidities in predicting health-related quality of life of people with multiple sclerosis. J Neurol. 2021;268(2):569-81. doi: https://doi.org/10.1007/s00415-020-10195-w
Marrie RA, Maxwell C, Mahar A, Ekuma O, McClintock C, Seitz D, et al. Cancer Incidence and Mortality Rates in Multiple Sclerosis: A Matched Cohort Study. Neurology. 2021 Jan 26;96(4):e501-e512. doi: https://doi:10.1212/wnl.0000000000011219
Marrie RA, Tremlett H, Kingwell E, et al. Disparities in management and outcomes of myocardial infarction in multiple sclerosis: a matched cohort study. Multiple Sclerosis J. 2020;26(12):1560-8. doi: https://doi.org/10.1177/1352458519876038
Nørgaard M, Veres K, Didden EM, Wormser D, Magyari M. Multiple sclerosis and cancer incidence: a Danish nationwide cohort study. Mult Scler Relat Disord. 2019;28:81-5. doi: https://doi.org/10.1016/j.msard.2018.12.014
Ogino M, Shiozawa A, Ota H, et al. Treatment and comorbidities of multiple sclerosis in an employed population in Japan: analysis of health claims data. Neurodegenerative Dis Manage. 2018;8(2):97-103. doi: https://doi.org/10.2217/nmt-2017-0047
Ohlmeier C, Gothe H, Haas J, et al. Epidemiology, characteristics and treatment of patients with relapsing remitting multiple sclerosis and incidence of high disease activity: Real world evidence based on German claims data. PloS One. 2020;15(5):e0231846. doi: https://doi.org/10.1371/journal.pone.0231846
Palladino R, Marrie RA, Majeed A, Chataway J. Evaluating the risk of macrovascular events and mortality among people with multiple sclerosis in England. JAMA Neurol. 2020;77(7):820-8. doi: https://doi.org/10.1001/jamaneurol.2020.0664
Persson R, Lee S, Yood MU, et al. Incident cardiovascular disease in patients diagnosed with multiple sclerosis: a multi-database study. Mult Scler Relat Disord. 2020;37:101423. doi: https://doi.org/10.1016/j.msard.2019.101423
Petrie A, Sabin C. Medical Statistics at a Glance. 4th edition. Wiley-Blackwell; 2019.
Petruzzo M, Reia A, Maniscalco GT, et al. The framingham cardiovascular risk score and 5-year pro-gression of multiple sclerosis. Eur J Neurol. 2021;28(3):893-900. doi: https://doi.org/10.1111/ene.14608
Salter A, Kowalec K, Fitzgerald KC, Cutter G, Marrie RA. Comorbidity is associated with disease activity in Ms: findings from the combirx trial. Neurology. 2020;95(5):e446-e56. doi: https://doi.org/10.1212
Thormann A, Sørensen PS, Koch-Henriksen N, et al. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality. Neurology. 2017;89(16):1668-75. doi: https://doi.org/10.1212
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