Higher comorbidities in MS tied to worse disease progression

A new study has revealed that people with multiple sclerosis (MS) who have multiple comorbidities experience worse clinical outcomes.

The research analysed data from 16,794 MS patients across 17 phase III trials of disease-modifying therapies between 2001 and 2018. It showed that individuals with three or more comorbidities had a 14% higher risk of disease activity over two years compared to those without comorbidities.

Comorbidities included conditions like hypertension, diabetes, autoimmune disorders, depression, anxiety, and heart disease. About 61% of participants showed evidence of disease activity, such as confirmed disability worsening, relapse, or new MRI-detected lesions. Cardiometabolic conditions (like heart disease and diabetes) and psychiatric disorders were associated with increased MS disease activity.

The study found that people with two or more cardiometabolic conditions had a 21% increased risk of disease activity. Depression and ischemic heart disease were specifically tied to a higher risk of disability worsening. Interestingly, comorbidities did not significantly increase the likelihood of developing new lesions, although ischemic heart disease and diabetes were linked to heightened lesion activity.

Researchers highlighted that people with severe comorbidities are often excluded from clinical trials, suggesting that the real-world impact of comorbidities on MS patients may be greater. They emphasised the need for better prevention and management of comorbidities in MS care, noting that they play a critical role in determining patient outcomes.

The research was presented at the annual European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting in Copenhagen.