Contributions
Abstract: EP1453
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Comorbidities can have a negative impact on disability in the multiple sclerosis (MS) population. However, disease modifying treatments (DMT), which prevent disease progression, could potentially moderate the effect of comorbidities. Little is known about the relationship between DMT use and comorbidities and its impact on disability.
Objective: To determine the impact of comorbidities and DMT use on disability in participants in the Pacific Northwest Multiple Sclerosis Registry.
Methods: Participant survey data collected between 2011 and 2016 were used. Participants who had progressive disease, reported use of more than one concurrent DMT, were on DMT less than six months if used DMT, or did not report time on DMT were excluded. Comorbidities included were cardiovascular disease, respiratory disease, smoking, cancer, thyroid disease, gastrointestinal (GI) disease, depression and obesity. Disability status was measured using the Patient Determined Disease Step (PDDS) score and disability was categorised as follows: none (0), mild (1 or 2) and moderate to severe (3 to 7). Polytomous logistic regression, adjusting for participant characteristics, was used to determine the impact of comorbidities and DMT use on reported disability status. Interactions between significant comorbidities and DMT use were tested in the regression model to investigate moderating effects.
Results: Survey data from 1,163 participants were analysed. Depression (33.6%, n=391), cardiovascular disease (29.0%, n=337), and respiratory disease (11.6%, n=135) were the most prevalent comorbidities. Participants were more likely to be moderately/severely disabled when they reported GI disease (Adjusted Odds Ratio (AOR) =4.09; p=.001), depression (AOR=3.20; p< .001), cardiovascular disease (AOR=2.21; p< .001), smoking (AOR=1.85; p=.004), and respiratory disease (AOR=1.43; p=0.05). For participants who smoked, DMT users had a decreased likelihood of being moderate or severely disabled (AOR=0.32; p=0.01). However, DMT use increased the likelihood of moderate to severe disability for those with depression (AOR=3.10; p< .001) and respiratory disease (AOR=3.67; p< .001). DMT had no moderating effect on those with GI or cardiovascular disease.
Conclusions: Results suggest the effects of smoking and depression on disability are moderated by DMT use, resulting in differing effects on disability. Further research is needed to understand the underlying mechanisms for these differences.
Disclosure: L. Lucas, T. Stuchiner, E. Baraban and C. Chen have no conflict of interest to report. S. Cohan has either served on advisory boards or steering committees for Biogen, Novartis, Sanofi Genzyme, and Mallinckrodt; have received research support from Biogen, Novartis, Sanofi Genzyme, Opexa, Teva, Mallinckrodt, and Roche; have received speaker honoraria from Biogen Idec, Novartis, Sanofi Genzyme and Acorda.
Abstract: EP1453
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Comorbidities can have a negative impact on disability in the multiple sclerosis (MS) population. However, disease modifying treatments (DMT), which prevent disease progression, could potentially moderate the effect of comorbidities. Little is known about the relationship between DMT use and comorbidities and its impact on disability.
Objective: To determine the impact of comorbidities and DMT use on disability in participants in the Pacific Northwest Multiple Sclerosis Registry.
Methods: Participant survey data collected between 2011 and 2016 were used. Participants who had progressive disease, reported use of more than one concurrent DMT, were on DMT less than six months if used DMT, or did not report time on DMT were excluded. Comorbidities included were cardiovascular disease, respiratory disease, smoking, cancer, thyroid disease, gastrointestinal (GI) disease, depression and obesity. Disability status was measured using the Patient Determined Disease Step (PDDS) score and disability was categorised as follows: none (0), mild (1 or 2) and moderate to severe (3 to 7). Polytomous logistic regression, adjusting for participant characteristics, was used to determine the impact of comorbidities and DMT use on reported disability status. Interactions between significant comorbidities and DMT use were tested in the regression model to investigate moderating effects.
Results: Survey data from 1,163 participants were analysed. Depression (33.6%, n=391), cardiovascular disease (29.0%, n=337), and respiratory disease (11.6%, n=135) were the most prevalent comorbidities. Participants were more likely to be moderately/severely disabled when they reported GI disease (Adjusted Odds Ratio (AOR) =4.09; p=.001), depression (AOR=3.20; p< .001), cardiovascular disease (AOR=2.21; p< .001), smoking (AOR=1.85; p=.004), and respiratory disease (AOR=1.43; p=0.05). For participants who smoked, DMT users had a decreased likelihood of being moderate or severely disabled (AOR=0.32; p=0.01). However, DMT use increased the likelihood of moderate to severe disability for those with depression (AOR=3.10; p< .001) and respiratory disease (AOR=3.67; p< .001). DMT had no moderating effect on those with GI or cardiovascular disease.
Conclusions: Results suggest the effects of smoking and depression on disability are moderated by DMT use, resulting in differing effects on disability. Further research is needed to understand the underlying mechanisms for these differences.
Disclosure: L. Lucas, T. Stuchiner, E. Baraban and C. Chen have no conflict of interest to report. S. Cohan has either served on advisory boards or steering committees for Biogen, Novartis, Sanofi Genzyme, and Mallinckrodt; have received research support from Biogen, Novartis, Sanofi Genzyme, Opexa, Teva, Mallinckrodt, and Roche; have received speaker honoraria from Biogen Idec, Novartis, Sanofi Genzyme and Acorda.