Abstract: 196
Type: Oral
Background: Comorbidity is prevalent in multiple sclerosis (MS) and may be associated with age of onset, delay of diagnosis, disability progression, working ability, health-related quality of life, and survival. Comorbidity increases with age and most studies have assessed the occurrence of comorbidity after the diagnosis of MS, while studies of the occurrence of comorbidity prior to the clinical onset of MS are sparse.
Methods: We studied non-vascular comorbidities in patients with MS comprising auto-immune diseases, Parkinson"s disease, chronic pulmonary diseases, malignant diseases, and psychiatric disorders, including both comorbidities occurring before and after the MS diagnosis. Main emphasis was made on new data from a combined case-control and cohort study of all registered Danish MS cases with clinical onset of MS between 1980 and 2005. The MS patients were randomly matched with five population controls by gender, year of birth, and municipality on 1 January in the year of MS onset. Individual-level information on comorbidity diagnosis was obtained from nationwide, population-based registries and linked to the study population by unique personal identification numbers.
Results: The study of co-occurrence of auto-immune diseases in MS has been conflicting. ImmunoChip analyses disclosed overlapping of approximately 22% of MS signals with at least one other autoimmune disease signal, most frequently with inflammatory bowel disease and less frequently with rheumatoid arthritis and autoimmune thyroid disease. However, studies comparing the prevalence of diabetes, rheumatoid arthritis and thyroid disease in MS patients to another population have variously reported the prevalence to be higher, lower or the same in the MS population. Parkinson"s disease was in the Danish cohort markedly increased in persons with MS after the clinical onset of MS. Inverse comorbidity was found regarding chronic lung diseases (asthma and chronic obstructive pulmonary disease), malignant disease (all cancers) and psychiatric diseases after the diagnosis of MS. Interestingly, we found decreased risk of cerebrovascular disease before onset of MS.
Conclusions: Although studies of comorbidity in MS have shown conflicting results, there seems to be important differences between MS cases and controls regarding the risk of comorbidities both before and after the clinical onset of MS, and the temporal risk of comorbidity risk varies over the course of MS.
Disclosure: P. S. Sørensen has received personal compensation for serving on scientific advisory boards, steering committees or independent data monitoring boards for Biogen Idec, Merck Serono, Novartis, Genzyme, Teva Pharmaceutical Industries Ltd., GlaxoSmithKline, medDay Pharmaceuticals and Forward Pharma and has received speaker honoraria from Biogen Idec, Merck Serono, Teva Pharmaceutical Industries Ltd., Genzyme, and Novartis.
Abstract: 196
Type: Oral
Background: Comorbidity is prevalent in multiple sclerosis (MS) and may be associated with age of onset, delay of diagnosis, disability progression, working ability, health-related quality of life, and survival. Comorbidity increases with age and most studies have assessed the occurrence of comorbidity after the diagnosis of MS, while studies of the occurrence of comorbidity prior to the clinical onset of MS are sparse.
Methods: We studied non-vascular comorbidities in patients with MS comprising auto-immune diseases, Parkinson"s disease, chronic pulmonary diseases, malignant diseases, and psychiatric disorders, including both comorbidities occurring before and after the MS diagnosis. Main emphasis was made on new data from a combined case-control and cohort study of all registered Danish MS cases with clinical onset of MS between 1980 and 2005. The MS patients were randomly matched with five population controls by gender, year of birth, and municipality on 1 January in the year of MS onset. Individual-level information on comorbidity diagnosis was obtained from nationwide, population-based registries and linked to the study population by unique personal identification numbers.
Results: The study of co-occurrence of auto-immune diseases in MS has been conflicting. ImmunoChip analyses disclosed overlapping of approximately 22% of MS signals with at least one other autoimmune disease signal, most frequently with inflammatory bowel disease and less frequently with rheumatoid arthritis and autoimmune thyroid disease. However, studies comparing the prevalence of diabetes, rheumatoid arthritis and thyroid disease in MS patients to another population have variously reported the prevalence to be higher, lower or the same in the MS population. Parkinson"s disease was in the Danish cohort markedly increased in persons with MS after the clinical onset of MS. Inverse comorbidity was found regarding chronic lung diseases (asthma and chronic obstructive pulmonary disease), malignant disease (all cancers) and psychiatric diseases after the diagnosis of MS. Interestingly, we found decreased risk of cerebrovascular disease before onset of MS.
Conclusions: Although studies of comorbidity in MS have shown conflicting results, there seems to be important differences between MS cases and controls regarding the risk of comorbidities both before and after the clinical onset of MS, and the temporal risk of comorbidity risk varies over the course of MS.
Disclosure: P. S. Sørensen has received personal compensation for serving on scientific advisory boards, steering committees or independent data monitoring boards for Biogen Idec, Merck Serono, Novartis, Genzyme, Teva Pharmaceutical Industries Ltd., GlaxoSmithKline, medDay Pharmaceuticals and Forward Pharma and has received speaker honoraria from Biogen Idec, Merck Serono, Teva Pharmaceutical Industries Ltd., Genzyme, and Novartis.