Contributions
Abstract: 146
Type: Free Communications
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: MS is the major permanently disabling neurological disease affecting young adults. Recent data on patients before and after MS diagnosis are sparse. We describe the comorbidity profile of MS patients at the time of diagnosis, the evolution of this profile, and concomitant medication use.
Methods: Using the UK CPRD, each MS patient diagnosed from 2001-2015 with ≥1 year of pre-diagnosis history was matched with up to 10 non-MS patients of comparable age, sex, and record history length. We identified comorbidities and medication use both at the time of and after the MS diagnosis date (or the matched date in non-MS patients).
Results: In total, 6932 MS patients were identified and compared with 68,526 non-MS patients (female, 70%; median age, 43 years). Relative to non-MS patients, MS patients in the time before diagnosis had an increased prevalence (p< 0.05) of depression (28.8 vs 23.2%), eye/ear infections (4.9 vs 3.2%), urinary tract infections (4.5 vs 2.9%), serious infections (1.9 vs 0.8%), autoimmune disorders (5.6 vs 4.7%), peripheral vascular disease (0.5 vs 0.2%), Raynaud's syndrome (1.4 vs 0.9%), macular oedema (0.2 vs 0.1%), and increased use of antidepressants (26.8 vs 13.5%), antipsychotics (9.3 vs 3.2%), antiepileptics (1.2 vs 0.8%), antihypertensives (15.9 vs 14.2%), proton pump inhibitors (13.3 vs 9.6%), antibiotics (35.0 vs 29.9%), and several symptomatic treatments. Over a median follow-up of 5 years post-diagnosis, MS patients had increased rates of a number of emergent comorbidities (incidence rate ratio; 95% confidence interval): spasticity (5.53; 4.96-6.17), neuropathy (4.43; 3.42-5.67), epilepsy (3.83; 2.79-5.17), osteoporosis (2.22; 1.82-2.68), non-depressive psychiatric disorder (2.14; 1.33-3.30), serious infection (2.0; 1.84-2.17), venous thromboembolism (1.94; 1.54-2.42), treated depression (1.90; 1.74-2.06), peripheral vascular disease (1.82; 1.17-2.72), suicidal behaviour (1.45; 1.04-1.97), fracture (1.41; 1.26-1.57), opportunistic infection (1.35; 1.26-1.45), bowel dysfunction (1.30; 1.12-1.50), major adverse cardiac event (1.28; 1.01-1.60), and herpes (1.20; 1.07-1.35). Cancer risk was not increased (0.96; 0.83-1.10). All-cause death was two-fold higher in MS patients.
Conclusion: MS patients experience considerable increased comorbidity risk in the period prior to formal MS diagnosis. Patients with MS have an increased risk of mortality and several major non-MS-related comorbidities post-diagnosis.
Disclosure: Susan Jick: Received grants from Celgene Corporation. Rebecca Persson: Received grants from Celgene Corporation. Sally Lee: Salaried employee of Celgene Corporation. Neil Minton: Salaried employee of Celgene Corporation. Steve Niemcryk: Salaried employee of Celgene Corporation. Anders Lindholm: Salaried employee of Celgene Corporation.
Abstract: 146
Type: Free Communications
Abstract Category: Clinical aspects of MS - Comorbidity
Introduction: MS is the major permanently disabling neurological disease affecting young adults. Recent data on patients before and after MS diagnosis are sparse. We describe the comorbidity profile of MS patients at the time of diagnosis, the evolution of this profile, and concomitant medication use.
Methods: Using the UK CPRD, each MS patient diagnosed from 2001-2015 with ≥1 year of pre-diagnosis history was matched with up to 10 non-MS patients of comparable age, sex, and record history length. We identified comorbidities and medication use both at the time of and after the MS diagnosis date (or the matched date in non-MS patients).
Results: In total, 6932 MS patients were identified and compared with 68,526 non-MS patients (female, 70%; median age, 43 years). Relative to non-MS patients, MS patients in the time before diagnosis had an increased prevalence (p< 0.05) of depression (28.8 vs 23.2%), eye/ear infections (4.9 vs 3.2%), urinary tract infections (4.5 vs 2.9%), serious infections (1.9 vs 0.8%), autoimmune disorders (5.6 vs 4.7%), peripheral vascular disease (0.5 vs 0.2%), Raynaud's syndrome (1.4 vs 0.9%), macular oedema (0.2 vs 0.1%), and increased use of antidepressants (26.8 vs 13.5%), antipsychotics (9.3 vs 3.2%), antiepileptics (1.2 vs 0.8%), antihypertensives (15.9 vs 14.2%), proton pump inhibitors (13.3 vs 9.6%), antibiotics (35.0 vs 29.9%), and several symptomatic treatments. Over a median follow-up of 5 years post-diagnosis, MS patients had increased rates of a number of emergent comorbidities (incidence rate ratio; 95% confidence interval): spasticity (5.53; 4.96-6.17), neuropathy (4.43; 3.42-5.67), epilepsy (3.83; 2.79-5.17), osteoporosis (2.22; 1.82-2.68), non-depressive psychiatric disorder (2.14; 1.33-3.30), serious infection (2.0; 1.84-2.17), venous thromboembolism (1.94; 1.54-2.42), treated depression (1.90; 1.74-2.06), peripheral vascular disease (1.82; 1.17-2.72), suicidal behaviour (1.45; 1.04-1.97), fracture (1.41; 1.26-1.57), opportunistic infection (1.35; 1.26-1.45), bowel dysfunction (1.30; 1.12-1.50), major adverse cardiac event (1.28; 1.01-1.60), and herpes (1.20; 1.07-1.35). Cancer risk was not increased (0.96; 0.83-1.10). All-cause death was two-fold higher in MS patients.
Conclusion: MS patients experience considerable increased comorbidity risk in the period prior to formal MS diagnosis. Patients with MS have an increased risk of mortality and several major non-MS-related comorbidities post-diagnosis.
Disclosure: Susan Jick: Received grants from Celgene Corporation. Rebecca Persson: Received grants from Celgene Corporation. Sally Lee: Salaried employee of Celgene Corporation. Neil Minton: Salaried employee of Celgene Corporation. Steve Niemcryk: Salaried employee of Celgene Corporation. Anders Lindholm: Salaried employee of Celgene Corporation.