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Abstract Details

Increased Risk of Comorbidities in Patients Before and After Multiple Sclerosis Diagnosis and Initiation of Treatment: A Study Using the US Department of Defense Database
Multiple Sclerosis
P4 - Poster Session 4 (5:30 PM-6:30 PM)
15-058
Describe comorbidities among multiple sclerosis (MS) patients.
Data on comorbidities in MS patients are sparse. 

US Department of Defense database of MS patients diagnosed January 2004-August 2017 with ≥1 year history before MS diagnosis were matched to non-MS patients on age, sex, and geographic region. We compared comorbidities and medications at and after diagnosis/matched date.

8,695 MS patients were compared with 86,934 non-MS patients (female, 71%; median age, 41). Prediagnosis, MS patients had increased prevalences (P<0.05) of depression (22.7% vs 16.4%), other psychiatric diagnoses (9.8% vs 6.7%), asthma (4.5% vs 3.7%), fracture (4.3% vs 3.5%), suicidal behaviors (1.3% vs 0.9%), epilepsy (0.8% vs 0.4%), and infection incidence the year before diagnosis/match (46.5% vs 38.3%); more used antibiotics (46.6% vs 35.1%), antidepressants (28.4% vs 16.7%), antihypertensives (24.0% vs 19.1%), proton pump inhibitors (15.9% vs 12.1%), anti-asthmatics (10.5% vs 8.4%), antipsychotics (3.1% vs 1.6%), antiplatelets (1.8% vs 0.9%), antiepileptics (1.7% vs 0.6%), and symptomatic treatments. Postdiagnosis (median, 7 years), MS patients had increased comorbidities (incidence rate ratio (IRR) [95% CI]): epilepsy (4.90 [4.17-5.73]), spasticity (4.86 [4.68-5.05]), neuropathy (3.78 [3.55-4.03]), treated depression (3.12 [2.98-3.27]), venous thromboembolism (2.54 [2.14-3.0]), peripheral vascular disease (2.49 [1.89-3.25]), hospitalized infection (2.43 [2.23-2.63]), retinal edema (2.19 [1.31-3.50]), myocardial infarction (2.11 [1.56-2.80]), major cardiac event (2.09 [1.70-2.55]), bowel dysfunction (2.05 [1.91-2.20]), suicidal behavior (1.97 [1.73-2.24]), osteoporosis (1.86 [1.65-2.10]), fracture (1.80 [1.66-1.95]), nondepressive psychiatric disorder (1.75 [1.64-1.85]), any herpes virus (1.48 [1.39-1.57]), opportunistic infection (1.50 [1.44-1.56]), asthma (1.40 [1.26-1.56]). Cancer IRR was similar between groups (1.18 [1.05-1.32]).

Treated MS patients experience increased comorbidities before and after diagnosis.

The views expressed in this abstract reflect the results of research conducted by the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

Authors/Disclosures

PRESENTER
No disclosure on file
Marianne Ulcickas Yood, DSc (EpiSource) No disclosure on file
Michael R. Wagner, MD (US Navy) No disclosure on file
No disclosure on file
No disclosure on file
Neil Minton Neil Minton has received personal compensation for serving as an employee of Bristol Myers Squibb. Neil Minton has received stock or an ownership interest from Bristol Myers Squibb.
Steve Niemcryk No disclosure on file
Anders Lindholm, MD, PhD No disclosure on file
No disclosure on file