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. 2015 Mar;21(3):332-41.
doi: 10.1177/1352458514564488. Epub 2014 Dec 23.

The incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in multiple sclerosis: a systematic review

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

The incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in multiple sclerosis: a systematic review

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

Abstract

Background: As new disease-modifying therapies emerge a better knowledge of the risk of comorbid disease in multiple sclerosis (MS) is needed.

Objective: To estimate the incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in MS.

Methods: We systematically reviewed the world literature by searching PUBMED, EMBASE, SCOPUS, the Web of Knowledge, and reference lists of retrieved articles. For selected articles, one reviewer abstracted data using a standardized form. The abstraction was verified by a second reviewer. The quality of all selected studies was assessed. For population-based studies we quantitatively assessed studies using the I² statistic, and conducted random effects meta-analyses.

Results: Study designs were heterogeneous with respect to populations, case definitions, and methods of ascertainment. Incidence of the studied comorbidities was rarely reported. Irritable bowel syndrome and chronic lung disease had a prevalence of more than 10% in the MS population. Irritable bowel syndrome, fibromyalgia, cataracts and glaucoma were more common than expected in the MS population.

Conclusion: Although they have been the subject of less study than other comorbidities, irritable bowel syndrome, arthritis, and chronic lung disease are common in the MS population and occur more often than expected when compared to the general population.

Keywords: Multiple sclerosis; cataracts; comorbidity; gastrointestinal; glaucoma; incidence; lung; prevalence; systematic review.

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Conflict of interest statement

Conflict of interest: Ruth Ann 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, and Rx & D Health Research Foundation, and has conducted clinical trials funded by Sanofi-Aventis.

Nadia Reider reports no disclosures.

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.

Per Soelberg 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 Incorporated, Genzyme, Medimmune, Novartis, Nuron Biotech, Spiniflex Pharmaceuticals, Somahlution, and Teva Pharmaceuticals; receives royalties from publishing Evaluation of Health Promotion and Disease Prevention (The McGraw Hill Companies, 1984); has received honoraria from GlaxoSmithKline, 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, and 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.

Jeffrey Cohen reports personal compensation for consulting from EMD Serono, Genentech, Genzyme, Innate Immunotherapeutics, Novartis, and Vaccinex. Dr. 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.

Figures

Figure 1.
Figure 1.
Forest plot of the prevalence of asthma in multiple sclerosis in population-based studies.
Figure 2.
Figure 2.
Forest plot of the prevalence of lung disease in multiple sclerosis in population-based studies.
See this image and copyright information in PMC

References

    1. Tremlett HL, Yoshida EM, Oger J. Liver injury associated with the {beta}-interferons for MS: A comparison between the three products. Neurology 2004; 62: 628–631. - PubMed
    1. Cohen JA. Emerging therapies for relapsing multiple sclerosis. Arch Neurol 2009; 66: 821–828. - PubMed
    1. Jain N, Bhatti MT. Fingolimod-associated macular edema: incidence, detection, and management. Neurology 2012; 78: 672–680. - PubMed
    1. Cossburn M, Pace AA, Jones J, et al. Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort. Neurology 2011; 77: 573–579. - PubMed
    1. Cohen JA, Coles AJ, Arnold DL, et al. Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial. Lancet. 2012; 380: 1819–28. - PubMed

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