Frequency of comorbidity in multiple sclerosis and neuromyelitis optica spectrum disorder: a retrospective longitudinal study

Background: The impact of comorbidities in multiple sclerosis (MS) is very important that exert a significant influence on general health and patients’ lifestyle. Generally, comorbidities are usually associated with adverse health outcomes among people, increased cost of medication, and decreased quality of life. Previously, co-existence of multiple sclerosis and other diseases has been reported in the literature. Based on this, in present study, we aimed to evaluate the prevalence of autoimmune and systemic comorbidities among patients with MS and neuromyelitis optica spectrum disorder (NMOSD). Method: A total of 2163 patients (1965 MS and 198 NMOSD) referred to the MS clinic of Kashani Hospital, throughout one year. Sex, age, marital status, body mass index (BMI), the annual relapse rate, disease duration, and the age of the onset of the disease were recorded. Moreover, expanded Disability Status Scale (EDSS) was also measured in all groups.Results: This study comprised MS and NMOSD patients with the mean age of 37.47±9.78 ranged from 12-79 years old. Twenty six different autoimmune and twenty five systemic diseases were evaluated among patients. According to the obtained results, the proportion with a claim for rheumatoid arthritis (RA), type 1 diabetes, autoimmune hepatitis, and Psoriasis were increased amongst patients with MS, while the prevalence of lupus was elevated in NMOSD patients. In addition, the most common systemic diseases in MS patients were urine disease, memory disease, headache, and concentration, however, claims for urine disease, memory disease, headache, and epilepsy were observed among NMOSD patients. The mean of first EDSS score (p<0.001), current EDSS score (p<0.001), and age of the onset of symptoms (p<0.001) was less among MS patients compared to NMOSD group.Conclusion: MS and NMOSD are associated with a variety of different types of diseases. These comorbidities are highly prevalent in MS and NMOSD throughout the disease course and may exacerbate disability progression in patients. The present study indicates that several autoimmune and systemic diseases co-exist with MS and NMOSD patients. More future works are needed to represent more targets to improve treatment strategy and management of these diseases.

Keywords:

multiple sclerosis , neuromyelitis optica spectrum disorder , comorbidity