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. 2015 Mar;21(3):282-93.
doi: 10.1177/1352458514564490. Epub 2014 Dec 22.

A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis

Ruth Ann Marrie  1 , Nadia Reider  2 , Jeffrey Cohen  3 , Olaf Stuve  4 , Per S Sorensen  5 , Gary Cutter  6 , Stephen C Reingold  7 , Maria Trojano  8
Affiliations

A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis

Ruth Ann Marrie et al. Mult Scler. 2015 Mar.

Abstract

Background: As new therapies emerge which increase the risk of autoimmune disease it is increasingly important to understand the incidence of autoimmune disease in multiple sclerosis (MS).

Objective: The purpose of this review is to estimate the incidence and prevalence of comorbid autoimmune disease in MS.

Methods: The PUBMED, EMBASE, SCOPUS and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles were searched, and abstracts were independently screened by two reviewers. The data were abstracted by one reviewer using a standardized data collection form, and the findings were verified by a second reviewer. We assessed quality of the included studies using a standardized approach and conducted meta-analyses of population-based studies.

Results: Sixty-one articles met the inclusion criteria. We observed substantial heterogeneity with respect to the populations studied, methods of ascertaining comorbidity, and reporting of findings. Based solely on population-based studies, the most prevalent autoimmune comorbidities were psoriasis (7.74%) and thyroid disease (6.44%). Our findings also suggest an increased risk of inflammatory bowel disease, likely uveitis and possibly pemphigoid.

Conclusion: Fewer than half of the studies identified were of high quality. Population-based studies that report age, sex and ethnicity-specific estimates of incidence and prevalence are needed in jurisdictions worldwide.

Keywords: Multiple sclerosis; autoimmune disease; comorbidity; incidence; prevalence.

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Conflict of interest statement

Conflict of interest: Ruth A Marrie receives research funding from: Canadian Institutes of Health Research, Public Health Agency of Canada, Manitoba Health Research Council, Health Sciences Centre Foundation, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Foundation, Rx & D Health Research Foundation, and has conducted clinical trials funded by Sanofi-Aventis.

Jeffrey Cohen reports personal compensation for consulting from EMD Serono, Genentech, Genzyme, Innate Immunotherapeutics, Novartis, and Vaccinex. Jeffrey Cohen receives research support paid to his institution from Biogen Idec, Consortium of MS Centers, US Department of Defense, Genzyme, US National Institutes of Health, National MS Society, Novartis, Receptos, Synthon, Teva, and Vaccinex.

Olaf Stuve is an associate editor of JAMA Neurology, and he serves on the editorial boards of the Multiple Sclerosis Journal, Clinical and Experimental Immunology, and Therapeutic Advances in Neurological Disorders. He has participated in data and safety monitoring committees for Pfizer and Sanofi. Olaf Stuve has received grant support from Teva Pharmaceuticals.

Per S Sorensen has received personal compensation for serving on scientific advisory boards, steering committees, independent data monitoring boards in clinical trials, or speaking at scientific meetings from Biogen Idec, Merck Serono, Novartis, Genmab, TEVA, GSK, Genzyme, Bayer Schering, Sanofi-aventis and MedDay pharmaceuticals. His research unit has received research support from Biogen Idec, Merck Serono, TEVA, Sanofi-aventis, Novartis, RoFAR, Roche, and Genzyme.

Gary Cutter has served on scientific advisory boards for and/or received funding for travel from Innate immunity, Klein-Buendel Inc., Genzyme, Medimmune, Novartis, Nuron Biotech, Spiniflex Pharmaceuticals, Somahlution, Teva pharmaceuticals; receives royalties from publishing Evaluation of health promotion and disease prevention (McGraw Hill, 1984); has received honoraria from Glaxo-SmithKline, Novartis, Advanced Health Media Inc., Biogen Idec, EMD Serono Inc., EDJ Associates, Inc., the National Heart, Lung, and Blood Institute, National Institute of Neurological Diseases and Stroke, National Marrow Donor Program, Consortium of Multiple Sclerosis Centers; Mt. Sinai School of Medicine and Teva Pharmaceuticals; has served on independent data and safety monitoring committees for Apotek, Ascendis, Biogen-Idec, Cleveland Clinic, Glaxo Smith Klein Pharmaceuticals, Gilead Pharmaceuticals, Modigenetech/Prolor, Merck/Ono Pharmaceuticals, Merck, Neuren, PCT Bio, Teva, Vivus, NHLBI (Protocol Review Committee), NINDS, NMSS, NICHD (OPRU oversight committee).

Stephen Reingold reports personal consulting fees from the National Multiple Sclerosis Society (NMSS) and the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), during the conduct of this work; and over the past three years, personal consulting fees from Bayer HealthCare, Biogen Idec, Coronado Biosciences Inc., the Cleveland Clinic Foundation, Eli Lilly & Company, from EMD Serono and Merck Serono, Genentech, F Hoffmann-LaRoche, Ironwood Pharmaceuticals Inc., ISIS Pharmaceuticals Inc., Medimmune Inc., Novartis Pharmaceuticals Corporation, Observatoire Français de la Sclérosis en Plaques, Opexa Therapeutics, Sanofi-Aventis, SK Biopharmaceuticals, Synthon Pharmaceuticals Inc., TEVA Pharmaceutical Industries, and Fondation pour l’aide à la Recherche sur la Sclérosis en Plaques, for activities outside of the submitted work.

Maria Trojano has served on scientific Advisory Boards for Biogen Idec, Novartis and Merck Serono; has received speaker honoraria from Biogen-Idec, Sanofi Aventis, Merck-Serono, Teva and Novartis; has received research grants from Biogen-Idec, Merck-Serono, and Novartis.

Nadia Reider reports no disclosures.

Figures

Figure 1.
Figure 1.
Forest plot of the prevalence of diabetes in multiple sclerosis in population-based studies.
Figure 2.
Figure 2.
Forest plot of the incidence of autoimmune thyroid disease in multiple sclerosis in population-based studies.
Figure 3.
Figure 3.
Forest plot of the prevalence of autoimmune thyroid disease in multiple sclerosis in population-based studies.
Figure 4.
Figure 4.
Forest plot of the incidence of rheumatoid arthritis in multiple sclerosis in population-based studies.
Figure 5.
Figure 5.
Forest plot of the prevalence of rheumatoid arthritis in multiple sclerosis in population-based studies.
See this image and copyright information in PMC

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