January 28, 2015
Unfair as it seems, MS doesn’t keep other disorders away. It’s possible to have MS and “something else” at the
same time. A new international initiative is being launched to understand how common it is for people with MS to
have other conditions and how these other conditions may impact the course and treatment of an individual’s MS.
The first stage of this project is now published, in preparation for an international scientific workshop jointly
supported by the National MS Society and the European Committee for Treatment and Research in MS (ECTRIMS)
to focus attention on comorbidities and determining next steps to finding solutions for people with MS.
Background: In scientific terms, having two chronic medical conditions at once is called “comorbidity.” There is
growing recognition that comorbidities may complicate the diagnosis of MS and also influence disease progression,
as well as an individual’s wellness and quality of life. In addition MS some other disorders may have risk factors in
common. For these reasons, the MS Comorbidities Project is seeking to characterize the types and frequencies of
comorbidities in MS in advance of a scientific meeting to map out next steps for research strategies to address this
gap area. This project is being undertaken by the International Advisory Committee on Clinical Trials in MS, a
committee comprised of international leaders in MS research and clinical care that is jointly supported by the
National MS Society and ECTRIMS.
The first phase of this project was a systematic review of existing published studies related to specific medical
conditions in people who have MS. Ruth Ann Marrie, MD, PhD (University of Manitoba) and colleagues* in
Denmark, Italy and the U.S., now report their findings in seven papers published in the MS Journal. (Read overview
and companion papers; no subscription is needed.) The review was supported in part by the National MS Society
(U.S.A.) and a Don Paty Career Development Award from the MS Society of Canada.
Review Results: The authors identified more than 7,000 studies on a variety of comorbidities and MS, and
narrowed these down, completing a full-text review of 249 studies that were conducted between 1905 and 2012.
Most were conducted in North America or Europe, leading the authors to comment that little is known about
comorbidities that occur with MS in Central or South America, Asia, or Africa. In addition, the quality and design of
the studies were so variable that it was difficult to compare results. Nevertheless, their extensive research yielded
these highlights, among many others:
• The five most prevalent disorders occurring alongside MS were depression, anxiety, high blood pressure, high
cholesterol, and chronic lung disease.
• The most prevalent autoimmune diseases occurring with MS were thyroid disease and psoriasis.
• The types of cancer that occurred most often in people with MS were cervical, breast, and digestive system
cancers. There appeared to be a higher than expected risk of meningiomas and urinary system cancers, and a
lower than expected risk of pancreatic, ovarian, prostate and testicular cancer, compared to the general population.
• Some disorders were found more often than expected by the investigators based on previous research, such as
heart disease, congestive heart failure, stroke, arthritis, inflammatory bowel disease, irritable bowel syndrome,
seizure disorders, bipolar disorder, sleep disorders, and alcohol abuse.
Comment: The authors suggest that further work is necessary to develop data sources that examine MS
comorbidities worldwide, and that are specific to individuals of different ages, genders, and ethnicities. They also
conclude that efforts should be coordinated so that methodologies are similar and results can be compared.
To this end, the Society and ECTRIMS are convening a workshop that will move this research forward. The
International Advisory Committee on Clinical Trials in MS and other experts in MS research will meet in spring 2015
to discuss next research steps, such as available data that may facilitate further research and which comorbidities
demand more immediate focus.
Read tips for managing MS when you have other medical conditions.
* Co-authors on the 7 papers are Drs. Ruth Ann Marrie (University of Manitoba), Jeffrey Cohen (Cleveland Clinic),
Olaf Stuve (University of Texas Southwestern), Maria Trojano (University of Bari), Per Soelberg Sørensen
(Copenhagen University Hospital Rigshospitalet), Stephen Reingold (Scientific and Clinical Review Associates,
LLC), Gary Cutter (University of Alabama at Birmingham) and Nadia Reider (University of Manitoba)
About Multiple Sclerosis
Multiple sclerosis, an unpredictable, often disabling disease of the central nervous system, interrupts
the flow of information within the brain, and between the brain and body. Symptoms range from
numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of
MS in any one person cannot yet be predicted, but advances in research and treatment are moving
us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50,
with at least two to three times more women than men being diagnosed with the disease. MS affects
more than 2.3 million people worldwide.
