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MS: Comorbidities Common at Diagnosis

Image Source: TOPNEWS

Patients newly diagnosed with multiple sclerosis (MS) often have other chronic medical conditions, with fibromyalgia, inflammatory bowel disease, and epilepsy being common physical comorbidities, and depression and bipolar disorder the most common psychiatric comorbidities, new research suggests.

Investigators, led by Ruth Ann Marrie, MD, University of Manitoba, Winnipeg, Canada, also found some interesting sex differences. In particular, women with MS were more likely to have chronic lung disease, while men with MS had a disproportionately higher prevalence of hypertension, diabetes, and epilepsy and of all of the psychiatric comorbidities studied (depression, anxiety, bipolar disorder, and schizophrenia).

The researchers note that the burden of psychiatric comorbidity for both sexes was striking.

"Depression and anxiety adversely affect health-related quality of life, adherence to therapy, and the risk of hospitalization. Therefore, our findings suggest that these comorbidities deserve particular clinical attention from the time of diagnosis, and support the need for studies aimed at improved diagnosis and management of these conditions," they write.

The study was published online March 9 in Neurology.

Implications for Medication Choice

The investigators stress that clinicians need to be aware of any comorbidities when prescribing MS medication because they can affect drug choice.

For example, individuals with migraine may have more difficulty tolerating β interferon because of worsening headache, and diabetes increases the risk for macular edema associated with fingolimod.

Dr Marrie further states in an American Academy of Neurology press release that the current study "raises the question of whether there are shared risk factors for both MS and these other diseases, and if so, whether we could eventually find ways to reduce the risk of both MS and the other diseases."

"Studies have shown that MS may progress faster for people who also have other chronic conditions, so it's important for people and their doctors to be aware of this and try to manage these conditions," she added.

  For the study, researchers examined how common several chronic conditions were in 23,382 patients with MS at the time of their diagnosis and 116,638 matched controls. The conditions included were hypertension, diabetes, hyperlipidemia, heart disease, chronic lung disease, epilepsy, fibromyalgia, inflammatory bowel disease, depression, anxiety, bipolar disorder, and schizophrenia.

Of the patients with MS, 71.9% were female. The most prevalent comorbidity was depression, which was present in 19% of patients. Compared to the matched population, all comorbidities except hyperlipidemia were more common in the MS population, and several had rate ratios of 2 or more, suggesting at least double the prevalence in the MS cohort.

Story Source: The above story is based on materials provided by MEDSCAPE
Note: Materials may be edited for content and length

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