Many people with MS have additional disorders or diseases (referred to as ‘comorbidities’). There is growing evidence that comorbidities may contribute to the variability in outcomes experienced by people with MS. Here, we highlight the key messages from a recent review of the subject by Prof Ruth Ann Marrie, an expert on comorbidities in people with MS.1
Among people with MS, disability progresses more quickly in those who have ‘vascular’ diseases (including diabetes, high blood pressure and heart disease) or are overweight than in those without these comorbidities. Health-related quality of life may also be poorer in people with comorbid depression or anxiety – the two most common comorbidities in people with MS. Furthermore, comorbidities can affect the safety, tolerability and effectiveness of disease-modifying therapies used to treat MS, potentially limiting the choice of suitable treatments.
Many of the comorbidities that have a negative effect on outcomes in people with MS are preventable or treatable. Prof. Marrie highlights the need for early identification of comorbidities and specifically recommends (1) screening for vascular comorbidities and (2) early identification of depression and anxiety. In addition, Prof. Marrie calls on healthcare professionals to empower people with MS to live healthy lifestyles (for more information, read ‘Six ways to lead a brain-healthy lifestyle’). Finally, once comorbidities are identified, Prof. Marrie argues that they should be treated as a clinical priority, concluding, “…we need to think about modifying comorbidity to improve outcomes”.
- Marrie RA. Comorbidity in multiple sclerosis: implications for patient care. Nat Rev Neurol 2017; doi:10.1038/nrneurol.2017.33.