Comorbidities Among MS Patients in US Range from High Cholesterol and Blood Pressure to Anxiety, Study Reports

Comobidities are common in multiple sclerosis (MS) patients in the U.S., with the most frequent being high cholesterol and blood pressure, followed by gastrointestinal disease, thyroid disease, and anxiety, a database analysis reports.

But distinctions exist between the sexes, this claims analysis found.

High cholesterol and blood pressure, as well as diabetes and alcohol abuse, were more common among male patients than female. Women, however, were more likely to file for problems related to gastrointestinal and thyroid diseases, chronic lung disease, arthritis, anxiety, and depression.

The study, “Comorbidity in US patients with multiple sclerosis,” was published in the journal Patient Related Outcome Measures. The researchers were suppored in this work by EMD Serono (a division of Merck KGaA); one is a company employee.

Comorbidities are other conditions present in patients with a particular disease. In MS, these other illnesses — which can be independent — can have negative consequences, including a delay in MS diagnosis, greater disability progression, poorer quality of life, increased hospitalization rates, and a higher risk of death.  

Published studies of comorbidities in MS patients in the United States are limited, the researchers wrote.

The team conducted a retrospective study to assess comorbidity trends in U.S. patients with MS between 2006 to 2014. Researchers also looked for links between comorbid health problems and patients’ sex, age, and geographic region.

A large U.S. claims database — the IMS Health Real World Data Adjudicated Claims, which holds information on some 5 million patients — was used. Between 23,695 and 35,732 MS patients were among each year’s claims groups.

Most patients in the analysis were women (more than 75%) with a mean age of 46.7 to 47.8 years, and most lived in the Northeast or Midwest. Claims for comorbidities, however, were significantly more common in the Northwest and South than the Midwest or West.

The most common comorbidities were found to be hyperlipidemia (high cholesterol) and hypertension (high blood pressure),  present in 25.9% to 29.7% of MS patients in a given year.

These were followed by gastrointestinal disease (18.4%–21.2%) and thyroid disease (12.9% –17.1%). Chronic lung disease, arthritis, and diabetes affected 5% to 10% of all patients.

High cholesterol claims, which rose between 2006-09, stabilized through 2011 before declining through 2014. Likewise, hypertension claims rose though 2013, then dropped in the study’s final analysis year.

In contrast, claims for gastrointestinal disease, thyroid disease, and anxiety generally rose from 2006 to 2014.

The high rates of vascular diseases — high blood pressure and cholesterol and diabetes— was particularly troubling, the researchers noted, as these comobidities are associated with MS progression.

“A single vascular comorbidity at diagnosis was associated with a 51% increased risk of early gait disability, while two vascular comorbidities was associated with a 228% increased risk,” the study reported.

Based on the results, the researchers suggests a more comprehensive care approach may yield better outcomes for both MS patients and their caregivers.

“A better understanding of comorbidities in MS may improve patient support, health care services, and quality of life” they concluded.