Contributions
Abstract: P936
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Large MS cohorts in Western Europe and North America have characterized its phenotypes and comorbidities. Awareness has emerged with potential prevention and treatment of comorbidity to improve MS outcomes besides proper disease modifying treatment prescription. Unfortunately, differences and similarities in other continents have been poorly studied.
Objective: To describe the demographics, clinical phenotypes and comorbidities of MS patients under clinical care within the Programa de Esclerosis Múltiple UC in Chile.
Methods: For demographics and clinical phenotypes, a prospective clinical data base collected from January 2008 to April 2017 was reviewed. A randomly selected sub-cohort of patients was retrospectively assessed for relevant comorbidities according to diagnosis from electronic medical files.
Results: A total of 615 patients were included, mean age 41 ± 12.5 years, 71% female, mean disease duration 11 ± 7.7 years, median EDSS 1.0 (range 0 - 10). Phenotypes were classified as RIS (1%), CIS (5%), RR (76%), SP (12%) and PP (6%). DMT was prescribed in 72%. Comorbidity was assessed in 374 patients. No statistically significant differences were observed between included and excluded patients. More frequent comorbidities were affective disorder 44% (depression 30%, bipolar 5%, anxiety 7%, others 2%); current smoking 40%; alcohol consumption 13%; autoimmune thyroiditis 16% (other autoimmune disorders 2%); sleep disorders 12%; glucose intolerance or diabetes mellitus 11%; hypertension 10%; hypercholesterolemia 8%; migraine 9%; epilepsy 4.5%; cancer 3%; bariatric surgery 3%; uveitis 2%; and polycystic ovary syndrome 2%. Comparing different phenotypes, the inflammatory MS group (RIS/CIS/RR) had higher frequency of current smoking (43% vs 26%, p=0.01), and progressive MS patients (SP/PP) had higher frequency of depression (p=0.001) and hypertension (p=0.002).
Conclusions: MS clinical phenotypes and comorbidities in our cohort are similar to those described in the literature for the Western Europe or North America. Identification and prevention of potential environmental factors such as smoking in early MS, recognition of depression and cardiovascular risk in progressive MS or bariatric surgery in the whole group, with its relevance in the microbiome are of great impact for the clinical practice. More studies in different continents are still needed to define our differences and similarities.
Disclosure:
Ethel Ciampi Nothing to disclose
Reinaldo Uribe-San-Martin Nothing to disclose
Karolyn Molnar Nothing to disclose
Diego Reyes Nothing to disclose
Gino Maguida Nothing to disclose
Elianet Fonseca Nothing to disclose
Elizabeth Vergara Nothing to disclose
Ana Reyes Nothing to disclose
Claudia Càrcamo Nothing to disclose
Abstract: P936
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Large MS cohorts in Western Europe and North America have characterized its phenotypes and comorbidities. Awareness has emerged with potential prevention and treatment of comorbidity to improve MS outcomes besides proper disease modifying treatment prescription. Unfortunately, differences and similarities in other continents have been poorly studied.
Objective: To describe the demographics, clinical phenotypes and comorbidities of MS patients under clinical care within the Programa de Esclerosis Múltiple UC in Chile.
Methods: For demographics and clinical phenotypes, a prospective clinical data base collected from January 2008 to April 2017 was reviewed. A randomly selected sub-cohort of patients was retrospectively assessed for relevant comorbidities according to diagnosis from electronic medical files.
Results: A total of 615 patients were included, mean age 41 ± 12.5 years, 71% female, mean disease duration 11 ± 7.7 years, median EDSS 1.0 (range 0 - 10). Phenotypes were classified as RIS (1%), CIS (5%), RR (76%), SP (12%) and PP (6%). DMT was prescribed in 72%. Comorbidity was assessed in 374 patients. No statistically significant differences were observed between included and excluded patients. More frequent comorbidities were affective disorder 44% (depression 30%, bipolar 5%, anxiety 7%, others 2%); current smoking 40%; alcohol consumption 13%; autoimmune thyroiditis 16% (other autoimmune disorders 2%); sleep disorders 12%; glucose intolerance or diabetes mellitus 11%; hypertension 10%; hypercholesterolemia 8%; migraine 9%; epilepsy 4.5%; cancer 3%; bariatric surgery 3%; uveitis 2%; and polycystic ovary syndrome 2%. Comparing different phenotypes, the inflammatory MS group (RIS/CIS/RR) had higher frequency of current smoking (43% vs 26%, p=0.01), and progressive MS patients (SP/PP) had higher frequency of depression (p=0.001) and hypertension (p=0.002).
Conclusions: MS clinical phenotypes and comorbidities in our cohort are similar to those described in the literature for the Western Europe or North America. Identification and prevention of potential environmental factors such as smoking in early MS, recognition of depression and cardiovascular risk in progressive MS or bariatric surgery in the whole group, with its relevance in the microbiome are of great impact for the clinical practice. More studies in different continents are still needed to define our differences and similarities.
Disclosure:
Ethel Ciampi Nothing to disclose
Reinaldo Uribe-San-Martin Nothing to disclose
Karolyn Molnar Nothing to disclose
Diego Reyes Nothing to disclose
Gino Maguida Nothing to disclose
Elianet Fonseca Nothing to disclose
Elizabeth Vergara Nothing to disclose
Ana Reyes Nothing to disclose
Claudia Càrcamo Nothing to disclose