Vnitr Lek 2023, 69(5):294-298 | DOI: 10.36290/vnl.2023.058

Internal comorbidities and complications of multiple sclerosis therapy -don't be caught off guard!

Dominika Šťastná1, Jana Seňavová2, 3, Michaela Andělová1, Ingrid Menkyová1, 4, Otakar Pšenička5, Dana Horáková1
1 Neurologická klinika a Centrum klinických neurověd 1. LF UK a VFN v Praze
2 I. interní klinika - klinika hematologie 1. LF UK a VFN v Praze
3 BIOCEV, 1. LF UK v Praze
4 II. neurologická klinika LF UK a UNB, Bratislava
5 III. interní klinika - endokrinologie a metabolismu 1. LF UK a VFN v Praze

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, mainly affecting young adults. Factors positively influencing its course include early antiinflammatory treatment and the influencing of other comorbidities. The most common comorbidities occurring in MS patients with a higher frequency than in the general population are neurological, psychiatric, cardiovascular, metabolic and autoimmune. Just as comorbidity compensation affects the course of MS, in some cases, MS decompensation is associated with a worse course of associated diseases. Due to common risk factors and partially shared immunopathogenesis, treatment covering multiple conditions can be used, especially for some autoimmune diseases. On the other hand, some drugs may potentiate the development of other autoimmunity or disorder. A special topic is the side effects and complications of treatment (especially infections and malignancies) of disease-modifying therapies used in patients with MS. However, the potential treatment discontinuation carries significant risks and should always be discussed with the MS specialist. Therefore, close interdisciplinary collaboration is crucial.

Keywords: autoimmune diseases, disease­‑modifying therapies, comorbidities, drug interactions, adverse effects, multiple sclerosis.

Accepted: August 24, 2023; Published: September 12, 2023  Show citation

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Šťastná D, Seňavová J, Andělová M, Menkyová I, Pšenička O, Horáková D. Internal comorbidities and complications of multiple sclerosis therapy -don't be caught off guard! Vnitr Lek. 2023;69(5):294-298. doi: 10.36290/vnl.2023.058.
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    References

    1. Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020;6(14):1816-21. Go to original source...
    2. Stastna D, Drahota J, Lauer M, et al. The Czech National MS Registry (ReMuS): Data trends in multiple sclerosis patients whose first disease­‑modifying therapies were initiated from 2013 to 2021. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023. Go to original source...
    3. Šťastná D, Menkyová Ingrid, Horáková D. Vysoce účinná terapie již od první ataky - důležitý posun v léčbě roztroušené sklerózy? Neu praxi. 2023 Jan 1;24(1):40-4. Go to original source...
    4. Cerqueira JJ, Compston DAS, Geraldes R, et al. Time matters in multiple sclerosis: can early treatment and long­‑term follow­‑up ensure everyone benefits from the latest advances in multiple sclerosis? J Neurol Neurosurg Psychiatry. 2018;89(8):844-50. Go to original source...
    5. Kavaliunas A, Manouchehrinia A, Stawiarz L, et al. Importance of early treatment initiation in the clinical course of multiple sclerosis. Mult Scler. 2017;23(9):1233-40. Go to original source... Go to PubMed...
    6. Marrie RA, Horwitz R, Cutter G, et al. Comorbidity delays diagnosis and increases disability at diagnosis in MS. Neurology. 2009;72(2):117-4. Go to original source... Go to PubMed...
    7. Hauer L, Perneczky J, Sellner J. A global view of comorbidity in multiple sclerosis: a systematic review with a focus on regional differences, methodology, and clinical implications. Journal of Neurology. 2021;268:4066-77. Go to original source...
    8. Mirabella M, Annovazzi P, Brownlee W et al. Treatment Challenges in Multiple Sclerosis - A Continued Role for Glatiramer Acetate? Front Neurol. 2022;13:618. Go to original source...
    9. Brønnum­‑Hansen H, Koch­‑Henriksen N, Stenager E. Trends in survival and cause of death in Danish patients with multiple sclerosis. Brain. 2004;127(4): 844-50. Go to original source...
    10. Koudriavtseva T, Renna R, Plantone D, et al. Association between Anemia and Multiple Sclerosis. Eur Neurol. 2015;73(3-4):233-7. Go to original source...
    11. Tettey P, Siejka D, Simpson S, et al. Frequency of Comorbidities and Their Association with Clinical Disability and Relapse in Multiple Sclerosis. 2016;46(2):106-13. Go to original source...
    12. Marrie RA, Reider N, Cohen J, et al. A systematic review of the incidence and prevalence of cardiac, cerebrovascular, and peripheral vascular disease in multiple sclerosis. Multiple Sclerosis Journal. 2015;21(3):318-31. Go to original source... Go to PubMed...
    13. Bisson EJ, Finlayson ML, Ekuma O, et al. Multiple sclerosis is associated with low bone mineral density and osteoporosis. Neurol Clin Pract. 2019;9(5):391-9. Go to original source...
    14. Wens I, Dalgas U, Deckx N et al. Does multiple sclerosis affect glucose tolerance? Multiple Sclerosis Journal. 2013;20(9):1273-6. Go to original source... Go to PubMed...
    15. Oliveira SR, Colado Simão AN, Kallaur AP, et al. Disability in patients with multiple sclerosis: Influence of insulin resistance, adiposity, and oxidative stress. Nutrition. 2014;30(3):268-73. Go to original source...
    16. Gianfrancesco MA, Acuna B, Shen L, et al. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors. Obes Res Clin Pract. 2014;8(5):e435. Go to original source...
    17. Moss BP, Rensel MR, Hersh CM. Wellness and the Role of Comorbidities in Multiple Sclerosis. Neurotherapeutics. 2017;14(4):999-1017. Go to original source...
    18. Zikán MV. Skelet a roztroušená skleróza (habilitační práce), 2017.
    19. Constantinescu V, Haase R, Akgün K, et al. S1P receptor modulators and the cardiovascular autonomic nervous system in multiple sclerosis: a narrative review. Ther Adv Neurol Disord. 2022;15. Go to original source...
    20. Kappus N, Weinstock­‑Guttman B, Hagemeier J, et al. Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2016;87(2):181-7.
    21. Kowalec K, McKay KA, Patten SB, et al. Comorbidity increases the risk of relapse in multiple sclerosis: A prospective study. Neurology 2017;89(24):2455. Go to original source... Go to PubMed...
    22. Multiple Sclerosis­‑Simvastatin Trial 2 - Full Text View - ClinicalTrials.gov [citováno 2023-05-01]. Available from: https://clinicaltrials.gov/ct2/show/NCT03387670.
    23. Abdalla MA, Zakhary CM, Rushdi H, et al. The Effectiveness of Statins as Potential Therapy for Multiple Sclerosis: A Systematic Review of Randomized Controlled trials. Cureus. 2021;13(9). Go to original source...
    24. Huppke B, Ellenberger D, Hummel H, et al. Association of Obesity With Multiple Sclerosis Risk and Response to First­‑line Disease Modifying Drugs in Children. JAMA Neurol 2019;76(10):1157-65. Go to original source...
    25. Marrie RA, Patten SB, Greenfield J, et al. Physical comorbidities increase the risk of psychiatric comorbidity in multiple sclerosis. Brain Behav. 2016; 6(9). Go to original source... Go to PubMed...
    26. Hengstman GJD, Kusters B. Sudden cardiac death in multiple sclerosis caused by active demyelination of the medulla oblongata. Multiple Sclerosis Journal. 2011;17(9):1146-8. Go to original source... Go to PubMed...
    27. Crawley F, Saddeh I, Barker S, Katifi H. Acute pulmonary oedema: presenting symptom of multiple sclerosis. Mult Scler. 2001;7(1):71-2. Go to original source... Go to PubMed...
    28. Bayer AD, Cahill JF, Rizvi SA. Multiple sclerosis relapse presenting as an acute cardiomyopathy. Mult Scler Relat Disord. 2019;27:7-8. Go to original source... Go to PubMed...
    29. Koh YH, Ratnagopal P. Multiple sclerosis with intractable vomiting and atypical area postrema lesion. Mult Scler Relat Disord 2020; 45. Go to original source...
    30. Tiedje V, Schlamann M, Führer D, Moeller LC. Diabetes insipidus as a rare cause of acute cognitive impairment in multiple sclerosis. Mult Scler. 2013;19(12):1676-8. Go to original source... Go to PubMed...
    31. Miron G, Gurevich M, Baum S, et al. Psoriasis comorbidity affects multiple sclerosis neurological progression: a retrospective case - control analysis. Journal of the European Academy of Dermatology and Venereology 2017;31(12):2055-61. Go to original source... Go to PubMed...
    32. Zivadinov R, Raj B, Ramanathan M, et al. Autoimmune Comorbidities Are Associated with Brain Injury in Multiple Sclerosis. American Journal of Neuroradiology. 2016;37(6):1010-6. Go to original source... Go to PubMed...
    33. Ganesvaran G, Greer JM, Pender MP. Prominent brainstem and cerebellar involvement in multiple sclerosis with psoriasis. Mult Scler. 2009;15(6):763-6. Go to original source... Go to PubMed...
    34. Coles AJ, Jones JL, Vermersch P, et al. Autoimmunity and long­‑term safety and efficacy of alemtuzumab for multiple sclerosis: Benefit/risk following review of trial and post­‑marketing data. Mult Scler. 2022;28(5):842-6. Go to original source... Go to PubMed...
    35. Brummer T, Ruck T, Meuth SG, et al. Treatment approaches to patients with multiple sclerosis and coexisting autoimmune disorders. Ther Adv Neurol Disord. 2021;14. Go to original source... Go to PubMed...
    36. Brown JWL, Coles A, Horakova D, et al.Association of Initial Disease­‑Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis. JAMA 2019 321(2):175-87.
    37. Harding K, Williams O, Willis M, et al. Clinical Outcomes of Escalation vs Early Intensive Disease­‑Modifying Therapy in Patients With Multiple Sclerosis. JAMA Neurol. 2019;76(5):536-41. Go to original source... Go to PubMed...
    38. Státní ústav pro kontrolu léčiv [Cited 2023-05-01]. Available from: https://www.sukl.cz/.
    39. Buljevac D, Flach HZ, Hop WCJ, et al. Prospective study on the relationship between infections and multiple sclerosis exacerbations. Brain. 2002;125(5):952-60. Go to original source... Go to PubMed...
    40. Stastna D, Menkyova I, Drahota J et al. To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection. Mult Scler Relat Disord. 2022; 65(3):104014. Go to original source... Go to PubMed...
    41. Mailand MT, Frederiksen JL. Vaccines and multiple sclerosis: a systematic review. J Neurol. 2017;264(6):1035-50. Go to original source... Go to PubMed...
    42. Horakova D. Doporučení Výboru Sekce klinické neuroimunologie a likvorologie ČNS ČLS JEP. 2021 [Cited 2023-03-19]. Available from: www.aktivnizivot.cz.
    43. Suchopár Š, Prokeš M, Suchopár J. Přehled lékových interakcí specifických léků používaných u roztroušené sklerózy. Remedia. 2022;32:179-90.
    44. Prokeš M, Suchopár J. Přehled lékových interakcí a rizik specifických léků používaných u roztroušené sklerózy. Med praxi. 2016;13(5):e1-e8. Go to original source...
    45. Stastna D, Menkyova I, Drahota J, et al. Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia. Mult Scler Relat Disord. 2021;54:103104. Go to original source... Go to PubMed...

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