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Comorbidity increases the risk of relapse in multiple sclerosis

A study has found that multiple sclerosis (MS) patients with migraine, hyperlipidaemia or more than three comorbidities have an increased risk of relapse.

Comorbid conditions, such as diabetes and hypertension, are frequent in MS and are associated with increased hospitalisations, greater disability progression, mortality risk and contrast-enhancing lesions on brain MRI.

It has been proposed that comorbidity may explain part of the heterogeneity in outcomes, such as disability progression between individuals with MS. An emerging line of inquiry suggests a potential association between comorbidities and MS relapses, but studies have been limited.

This study recruited individuals with prevalent relapsing-onset MS from four Canadian MS Clinics to participate in a two-year prospective, multi-centre cohort study involving cross-sectional assessment of comorbidities and relapses.

Of 885 participants, 678 (76.6%) were women, with a mean age of 48.2 years. The most prevalent comorbidities were anxiety (40.2%), depression (21.1%), hypertension (17.7%), migraine (18.1%) and hyperlipidaemia (11.9%).

The frequency of participants experiencing relapses remained constant at 14.9% and 13.2% in years one and two respectively. After adjustment, participants reporting three or more comorbidities had a higher relapse rate over the subsequent two years. Specifically, migraine and hyperlipidaemia were also associated with increased relapse rate.

Scientists concluded that individuals with MS and migraine, hyperlipidaemia, or three or more comorbidities had an increased relapse rate over two years. They said: “These findings have potential implications for understanding the pathophysiology of MS relapses and may suggest closer monitoring of individuals with specific or multiple comorbidities is needed. Future research is needed to examine whether comorbidities warrant a tailored approach to MS management.”

This study was announced at ECTRIMS 2017. For more information, visit*ce_id=1278*ot_id=18245*media=3

Source: MS-UK

Date: 13/03/18

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