DMTs Do Not Moderate Disability in Patients With MS and Diabetes, Other Comorbidities

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All participants were smokers or had either diabetes, cancer, depression, cardiovascular, respiratory, thyroid, or gastrointestinal disease and were receiving a DMT.
All participants were smokers or had either diabetes, cancer, depression, cardiovascular, respiratory, thyroid, or gastrointestinal disease and were receiving a DMT.

The following article is part of conference coverage from the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from ECTRIMS 2018.

In patients with multiple sclerosis (MS) and diabetes, depression, or respiratory disease, several different types of disease-modifying therapies (DMTs) do not appear to exert a moderating effect on disability, according to a study presented at the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held October 10-12, 2018, in Berlin, Germany.

“Comorbidities may have a negative impact on disability in MS patients. MS disease modifying therapy (DMT) may potentially moderate the effect of comorbidities,” according to the researchers. “Little is known about the relationship between DMT use and comorbidities with regard to disability in people with MS.”

Self-reported data of participants in the Pacific Northwest Multiple Sclerosis Registry between 2011 and 2016 were included in the analysis (n=908). All participants were smokers or had either diabetes, cancer, depression, cardiovascular, respiratory, thyroid, or gastrointestinal disease and were receiving a DMT. The different types of DMTs in the sample included self-injectable (eg, beta interferons and glatiramer acetate, n=502), oral therapy (eg, teriflunomide, dimethyl fumarate, and fingolimod, n=310), and infusion (IV) therapy (eg, alemtuzumab, rituximab, natalizumab, and ocrelizumab, n=96).

Compared with the other comorbidities, moderate or greater disability was more likely to be reported in participants with diabetes (adjusted odds ratio [AOR] 2.83; P =.009), depression (AOR 2.10; P <.001), and respiratory disease (AOR 1.99; P =.004). The investigators found an interaction between DMT and diabetes; however, there were no differences in disability between each DMT type among patients with MS with diabetes in post-hoc comparisons.

“Increased cohort size of patients with comorbidities may reveal statistically significant DMT and comorbidity interactions,” the investigators concluded. “However, the impact of comorbidities may override the potential disability benefits of DMTs and should prompt clinicians to focus on the overall health of MS patients.”

Disclosures: This study was supported by Sanofi. Several authors report relationships with industry. Please refer to the original abstract for a full list of disclosures.

For more coverage of ECTRIMS 2018, click here.

Reference

Baraban E, et al. Impact of comorbidity and DMT use on disability status by DMT group in participants in the Pacific Northwest MS Registry. Presented at: 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis. October 10-12, 2018; Berlin, Germany. Abstract P1049.

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