Risk of MS Disability Progression Increases with Autoimmune Comorbidities

Study results published in Multiple Sclerosis and Related Disorders showed that multiple sclerosis (MS) patients with certain autoimmune comorbidities are at a higher risk of disability progression. The study examined the effect of concomitant Crohn disease (CD), ulcerative colitis (UC), and type 1 diabetes (T1D) on MS disability worsening. These findings highlight the importance of monitoring and managing comorbidities in MS patients to improve long-term outcomes.

The study included individuals from the Swedish MS register (SMSreg) with a definite MS diagnosis (between January 2004 and January 2019) according to McDonald criteria (N=8972). Groups were divided into the development of comorbidity (UC, CD, and T1D) before and after MS onset. The primary outcomes were risk of reaching sustained expanded disability scale status (EDSS) scores of 3.0 (moderate disability but no impairment of walking), 4.0 (significant disability but able to walk without aid or rest for 500 meters), or 6.0 (requires unilateral assistance to walk about 100 meters with or without resting). The median time to reach sustained disability milestones was estimated using Kaplan-Meier analysis, and the risk of reaching disability milestones among persons with and without CD, UC, or T1D was calculated using adjusted Cox proportional hazard regressions models.

• Individuals with MS and T1D had a significantly increased risk of reaching a EDSS score of 6.0 (hazard ratio [HR], 2.21; 95% CI, 1.48 to 3.13). 
• Individuals with MS and comorbid CD had a significantly increased risk of reaching EDSS scores of 3.0 (HR, 2.30; 95%CI, 1.74 to 3.04) and EDSS 4.0 (HR, 1.59; 95% CI, 1.09 to 2.32). 
• Individuals with MS and UC had a significantly increased risk of reaching a EDSS score of 3.0 (HR, 1.57; 95% CI, 1.15-2.14).