Dr Ruth Ann Marrie Discusses Comorbidities in Multiple Sclerosis

Ruth Ann Marrie, MD, PhD, director of the Multiple Sclerosis Clinic at the University of Manitoba, speaks about the overall prevalence of comorbidities in patients with multiple sclerosis (MS).


What is the overall prevalence of comorbidities in patients with multiple sclerosis (MS) and are there comorbidities that are more commonly present alongside MS?

Comorbid conditions are actually very common in multiple sclerosis throughout the disease course. But how common they are really varies as to where we are in the disease course. So, we look at people around the time of diagnosis, then we'll see that more than 1 in 10 individuals may have irritable bowel syndrome or chronic lung disease such as asthma. And up to 1 in 4 may have already had difficulty with depression or anxiety disorders, for example, but because many chronic conditions like diabetes or high blood pressure, high cholesterol, increase with age in the general population, we see that same phenomenon in people with MS. So by the time you get to be 60 years old with your multiple sclerosis, then probably half of individuals at least will have high blood pressure. Maybe a third might have high cholesterol and 1 in 10 might have diabetes, maybe even more. So it really doesn't matter where you're looking, of course, in terms of how frequent but it’s particularly important to recognize that some conditions occur more often in people with MS and people without MS. So we need to be particularly alert to those. Depression and anxiety disorders are examples of ones that are substantially more common—50% to 100% more common in individuals with MS. Possibly starting even at the time of their earliest symptom onset before they even know they have the diagnosis of multiple sclerosis. And when we looked at this in the Canadian population, we found that even at the time of MS diagnosis based on studies using health claims data, nearly all the health conditions that we've looked at, with the exception perhaps of high cholesterol, are more common in individuals with MS than without. So epilepsy and inflammatory bowel disease and psoriasis and hypertension and so on. People with MS really seem to have a high burden of comorbidity and it’s something we need to pay attention to from the very beginning.