Contributions
Abstract: EP1358
Type: ePoster
Abstract Category: Clinical aspects of MS - Natural course
Introduction: Comorbidities are known to affect multiple sclerosis (MS) patients in a number of ways, including delaying time to diagnosis and reducing health related quality of life. It is thought that comorbidities may also negatively impact the disease course. We sought to determine the effect of hypertension, hyperlipidemia, diabetes mellitus, and obstructive lung disease on clinical and radiologic outcomes in MS patients.
Methods: The Knowledge Program is a database linked to our electronic medical record allowing capture of patient and clinician reported outcomes. Through Knowledge Program query and chart review, we identified all relapsing-remitting MS patients seen between 1 January 2010 and 29 May 2012 and acquired their magnetic resonance imaging (MRI) results and comorbidities. Linear and logistic regression models with adjustment for important covariates were used to determine if the comorbidities affected outcomes over a 3-year period. The cumulative effect of multiple comorbidities was also examined. Clinical outcomes included the timed 25 foot walk, Performance Scales score (a questionnaire interrogating MS-related disability), and Patient Health Questionnaire 9 score (a depression measure). Radiologic outcomes included presence of new or enlarging T2 lesions and/or gadolinium enhancing lesions.
Results: Hypertension, diabetes mellitus, and obstructive lung disease, but not hyperlipidemia, impacted clinical outcomes, including walking speed, self-reported disability, and depression. Hypertension was the most deleterious with a significant effect on all three clinical outcomes. The presence of multiple comorbidities had a cumulative effect on clinical outcomes with predicted scores for all outcomes worsening in a dose-response fashion as the number of comorbidities increased. MRI outcomes were unaffected by comorbidities.
Conclusions: This 3-year longitudinal study revealed that all comorbidities tested except hyperlipidemia impacted clinical outcomes and a cumulative effect with multiple comorbidities was also observed. Radiographic outcomes were unaffected, suggesting the studied comorbidities may have a predominantly neurodegenerative effect that would not have been well captured in our dataset. It is unclear from our results if treatment of comorbidities results in better outcomes for MS patients, but this is an area that deserves further research.
Disclosure:
Devon Conway reports personal compensation for serving as a consultant to Arena Pharmaceuticals.
Nicolas Thompson: nothing to disclose.
Jeffrey Cohen reports personal compensation for consulting for Genentech, Genzyme, and Novartis and speaking for Teva.
Abstract: EP1358
Type: ePoster
Abstract Category: Clinical aspects of MS - Natural course
Introduction: Comorbidities are known to affect multiple sclerosis (MS) patients in a number of ways, including delaying time to diagnosis and reducing health related quality of life. It is thought that comorbidities may also negatively impact the disease course. We sought to determine the effect of hypertension, hyperlipidemia, diabetes mellitus, and obstructive lung disease on clinical and radiologic outcomes in MS patients.
Methods: The Knowledge Program is a database linked to our electronic medical record allowing capture of patient and clinician reported outcomes. Through Knowledge Program query and chart review, we identified all relapsing-remitting MS patients seen between 1 January 2010 and 29 May 2012 and acquired their magnetic resonance imaging (MRI) results and comorbidities. Linear and logistic regression models with adjustment for important covariates were used to determine if the comorbidities affected outcomes over a 3-year period. The cumulative effect of multiple comorbidities was also examined. Clinical outcomes included the timed 25 foot walk, Performance Scales score (a questionnaire interrogating MS-related disability), and Patient Health Questionnaire 9 score (a depression measure). Radiologic outcomes included presence of new or enlarging T2 lesions and/or gadolinium enhancing lesions.
Results: Hypertension, diabetes mellitus, and obstructive lung disease, but not hyperlipidemia, impacted clinical outcomes, including walking speed, self-reported disability, and depression. Hypertension was the most deleterious with a significant effect on all three clinical outcomes. The presence of multiple comorbidities had a cumulative effect on clinical outcomes with predicted scores for all outcomes worsening in a dose-response fashion as the number of comorbidities increased. MRI outcomes were unaffected by comorbidities.
Conclusions: This 3-year longitudinal study revealed that all comorbidities tested except hyperlipidemia impacted clinical outcomes and a cumulative effect with multiple comorbidities was also observed. Radiographic outcomes were unaffected, suggesting the studied comorbidities may have a predominantly neurodegenerative effect that would not have been well captured in our dataset. It is unclear from our results if treatment of comorbidities results in better outcomes for MS patients, but this is an area that deserves further research.
Disclosure:
Devon Conway reports personal compensation for serving as a consultant to Arena Pharmaceuticals.
Nicolas Thompson: nothing to disclose.
Jeffrey Cohen reports personal compensation for consulting for Genentech, Genzyme, and Novartis and speaking for Teva.