Contributions
Abstract: EP1438
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Objective: Our aim is to estimate the incidence of Venous Thromboembolic (VTE) disease in Multiple Sclerosis (MS) patients compared to those without MS, through a critical and systematic review of the literature. Additionally, if data is available we aim to assess if MS clinical features, such as MS type, disease duration and severity, are associated with a higher risk of VTE.
Methods: We searched PubMed and EMBASE. The records were initially screened using their titles then abstracts. Full text articles were read by two independent reviewers to assess if they met the following inclusion criteria: study population consists of patients with a confirmed diagnosis of MS according to the accepted diagnostic criteria at the time of the study; comparison group consists of patients with no diagnosis of MS; clinical outcomes include incidence rates of VTE events with Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) diagnostic strategies clearly stated, as well as risk ratios of MS vs non-MS. Data was extracted by one reviewer using a standardized form and verified by a second. A metanalysis was carried out using OpenMeta[Analyst] software. Each study was critically appraised using the Newcastle-Ottowa Quality Assessment scale.
Results: We included 7 articles and carried out a metanalysis on 6. The analysis showed MS to be associated with a 1.907 (95% confidence interval 1.676-2.171) increased risk of VTE. Studies varied greatly in design and quality. MS severity, secondary progressive MS, disability, steroid use, spasticity and antidepressant use were found to be associated with an increased risk of VTE.
Conclusion: This review highlights just how little research there is on this topic. The limited literature suggests that MS may confer an increased risk of VTE. It also suggests MS related factors such as spasticity, steroid use and disability may be associated with a higher risk of VTE in MS patients, but there is still uncertainty. More studies are needed to recognize these particular risk factors to allow risk stratification and identification of particular MS patients that may potentially benefit from VTE prophylaxis.
Disclosure:
Omnya Ahmed: Nothing to disclose
Ruth Geraldes: Has received support for scientific meetings and courses and honorariums for advisory work from Bioden Idec, Novartis, Alexion, Bayer Schering, Merck Serono
Ahmed Ahmed: Nothing to disclose
Jacqueline Palace: Has received support for scientific meetings and honorariums for advisory work from Merck Serono, ABIDE, Biogen Idec, Roche, Novartis, Alexion, Medimmune, Teva, Chugai Pharma and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Grants from the MS society. GMSI, NIHR and Guthy- Jackson Foundation for research studies. Run Nationally commissioned services for CMS and NMO.
Gabriele DeLuca: is supported by the NIHR Biomedical Research Centre (BRC), Oxford and has research funding from the Oxford BRC, MRC(UK), and Merck-Serono. G.C. DeLuca has received travel expenses from Bay Schering, Biogen Idec, Genzyme, Merck Serono, and Novartis, and honoraria as an invited speaker for Bayer Schering and Novartis.
Abstract: EP1438
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Objective: Our aim is to estimate the incidence of Venous Thromboembolic (VTE) disease in Multiple Sclerosis (MS) patients compared to those without MS, through a critical and systematic review of the literature. Additionally, if data is available we aim to assess if MS clinical features, such as MS type, disease duration and severity, are associated with a higher risk of VTE.
Methods: We searched PubMed and EMBASE. The records were initially screened using their titles then abstracts. Full text articles were read by two independent reviewers to assess if they met the following inclusion criteria: study population consists of patients with a confirmed diagnosis of MS according to the accepted diagnostic criteria at the time of the study; comparison group consists of patients with no diagnosis of MS; clinical outcomes include incidence rates of VTE events with Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) diagnostic strategies clearly stated, as well as risk ratios of MS vs non-MS. Data was extracted by one reviewer using a standardized form and verified by a second. A metanalysis was carried out using OpenMeta[Analyst] software. Each study was critically appraised using the Newcastle-Ottowa Quality Assessment scale.
Results: We included 7 articles and carried out a metanalysis on 6. The analysis showed MS to be associated with a 1.907 (95% confidence interval 1.676-2.171) increased risk of VTE. Studies varied greatly in design and quality. MS severity, secondary progressive MS, disability, steroid use, spasticity and antidepressant use were found to be associated with an increased risk of VTE.
Conclusion: This review highlights just how little research there is on this topic. The limited literature suggests that MS may confer an increased risk of VTE. It also suggests MS related factors such as spasticity, steroid use and disability may be associated with a higher risk of VTE in MS patients, but there is still uncertainty. More studies are needed to recognize these particular risk factors to allow risk stratification and identification of particular MS patients that may potentially benefit from VTE prophylaxis.
Disclosure:
Omnya Ahmed: Nothing to disclose
Ruth Geraldes: Has received support for scientific meetings and courses and honorariums for advisory work from Bioden Idec, Novartis, Alexion, Bayer Schering, Merck Serono
Ahmed Ahmed: Nothing to disclose
Jacqueline Palace: Has received support for scientific meetings and honorariums for advisory work from Merck Serono, ABIDE, Biogen Idec, Roche, Novartis, Alexion, Medimmune, Teva, Chugai Pharma and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Grants from the MS society. GMSI, NIHR and Guthy- Jackson Foundation for research studies. Run Nationally commissioned services for CMS and NMO.
Gabriele DeLuca: is supported by the NIHR Biomedical Research Centre (BRC), Oxford and has research funding from the Oxford BRC, MRC(UK), and Merck-Serono. G.C. DeLuca has received travel expenses from Bay Schering, Biogen Idec, Genzyme, Merck Serono, and Novartis, and honoraria as an invited speaker for Bayer Schering and Novartis.