Higher burden of comorbidity linked to worse clinical outcomes in multiple sclerosis

For people with multiple sclerosis (MS), a higher burden of comorbidity is associated with worse clinical outcomes, according to a study published online Sept. 18 in JAMA Neurology to coincide with the annual meeting of the European Committee for Treatment and Research in Multiple Sclerosis, held from Sept. 18 to 20 in Copenhagen, Denmark.

Amber Salter, Ph.D., from UT Southwestern Medical Center in Dallas, and colleagues examined the association of comorbidities with disease activity in clinical trials of disease-modifying therapies in populations with MS in a two-stage meta-analytic approach. The cohort study included individual participant data for 16,794 participants with MS from 17 phase 3 clinical trials of MS disease-modifying therapies.

The researchers found that 61.0% of the pooled trials had evidence of disease activity (EDA) during the two-year follow-up period. After adjustment for multiple factors, compared with no comorbidity, the presence of three or more comorbidities was associated with an increased risk for EDA (adjusted hazard ratio, 1.14).

The risk for EDA was also increased with the presence of two or more versus no cardiometabolic conditions (adjusted hazard ratio, 1.21). Increased hazard of EDA was seen in association with one psychiatric disorder (adjusted hazard ratio, 1.07).

“As these findings are coherent with observational studies using different study designs and data sources, evidence suggests that clinicians need to routinely address comorbidity in people with MS,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry; the study was based on research using data from pharmaceutical companies.

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