The following is a summary of “Comorbidities and their association with outcomes in the multiple sclerosis population: a rapid review,” published in the October 2024 issue of Neurology by Frank et al.
Multiple sclerosis (MS) was associated with a high burden of comorbidities that could affect patient health outcomes.
Researchers conducted a retrospective study to examine the associations between comorbidities and outcomes in individuals with MS.
They reviewed studies following the Cochrane Rapid Review Methods Group recommendations. MEDLINE, Embase, and the grey literature to identify studies examining the effects of comorbidities on disability progression, treatment initiation, and mortality among individuals with MS (100 primary studies, 88 different comorbidities). Data extraction and risk of bias assessments were systematically performed using the Newcastle-Ottawa scale and A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) criteria for observational studies and systematic reviews, respectively.
The results showed 100 primary studies encompassing 88 different comorbidities. Most study populations were between 60% and 80% female, with an average age of 30 to 45 years. Most included studies were conducted in Europe, North America, and Asia (specifically the Middle East). Over half (66%) of specific comorbidity-outcome relationships were examined within a single study only, and just 2 studies assessed treatment initiation as an outcome. Methods used to assess comorbidities and outcomes varied widely and included self-report measures, medical records, diagnostic codes, and standardized clinical assessments. Depression was consistently associated with greater disability (aHR: 1.50–3.59) and mortality (aHR: 1.62–3.55). Epilepsy was similarly associated with increased disability (aHR: 1.13–1.77) and increased mortality (aHR: 2.23–6.66). Diabetes was generally associated with increased mortality (aHR: 1.39–1.47), but results for disability were inconsistent. Most other conditions were examined in 1 or 2 studies only, and findings varied across studies, preventing clear conclusions. Anxiety was assessed in 24 studies. The findings varied in presence, direction, and strength, requiring nuanced interpretation.
They concluded that specific comorbidities were linked to worse disability progression and higher mortality risk in individuals with MS.
Source: msard-journal.com/article/S2211-0348(24)00519-4/fulltext
