Observational studyNeurology2016
Examining the effects of comorbidities on disease-modifying therapy use in multiple sclerosis.
Observational study in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- Measures of Comorbidities and Frailty in Multiple Sclerosis-Systematic Review on Evidence and Applicability of Utilized Scoring Systems in Clinical Routine and Real-World Data.European journal of neurology · 2025Pooled it
- Comorbidities, safety and persistence in phase III clinical trials in multiple sclerosis.Journal of neurology, neurosurgery, and psychiatry · 2025Pooled it
- A global view of comorbidity in multiple sclerosis: a systematic review with a focus on regional differences, methodology, and clinical implications.Journal of neurology · 2021Pooled it
- Impact of cancer on multiple sclerosis-related healthcare and disease-modifying drug use: A multinational cohort study.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Comorbidities at MS Diagnosis and Their Association With Treatment Persistence: Real-World Clinical Data.Brain and behavior · 2026Article
- Comorbidity and modifiable risk factors in multiple sclerosis.Therapeutic advances in neurological disorders · 2026Review
- The impact of autoimmune comorbidities on multiple sclerosis progression: insights from a longitudinal single-center study.Journal of neurology · 2025Article
- Should we stay or should we go? Recent insights on drug discontinuation in multiple sclerosis.Neurological research and practice · 2025Review
- A narrative review on the safety of glatiramer acetate in multiple sclerosis: focus on Europe.Therapeutic advances in chronic disease · 2025Review
- Real-world use of disease-modifying therapy in persons with multiple sclerosis aged 55 and over.BMJ neurology open · 2025Article
- Comorbidity and Disease Activity in Multiple Sclerosis.JAMA neurology · 2024Article
- Review
- Association of Clinical Relapses With Disease Outcomes in Multiple Sclerosis Patients Older Than 50 Years.Neurology · 2024Article
- Management of multiple sclerosis in older adults: review of current evidence and future perspectives.Journal of neurology · 2024Review
- [Comorbidities in multiple sclerosis and their influence on the choice of treatment].Revista de neurologia · 2024Review
- Disease-modifying drugs, multiple sclerosis and infection-related healthcare use in British Columbia, Canada: a population-based study.Lancet regional health. Americas · 2024Article
- Disease Modifying Strategies in Multiple Sclerosis: New Rays of Hope to Combat Disability?Current neuropharmacology · 2024Review
- The Barancik lecture: Comorbidity in multiple sclerosis-Looking backward, looking forward.Multiple sclerosis (Houndmills, Basingstoke, England) · 2023Article
- The economic impact of comorbidity in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Etiology, effects and management of comorbidities in multiple sclerosis: recent advances.Frontiers in immunology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
objectiveComorbidities are common in multiple sclerosis (MS) and adversely affect health outcomes. However, the effect of comorbidity on treatment decisions in MS remains unknown. We aimed to examine the effects of comorbidity on initiation of injectable disease-modifying therapies (DMTs) and on the choice of the initial DMT in MS.
methodsWe conducted a retrospective observational analysis using population-based health administrative and linked clinical databases in 3 Canadian provinces. MS cases were defined as any individual with ≥3 diagnostic codes for MS. Cohort entry (index date) was the first recorded demyelinating disease-related claim. The outcomes included choice of initial first-line DMTs and time to initiating a DMT. Logistic and Cox regression models were used to examine the association between comorbidity status and study outcomes, adjusting for sex, age, year of index date, and socioeconomic status. Meta-analysis was used to estimate overall effects across the 3 provinces.
resultsWe identified 10,698 persons with incident MS, half of whom had ≥1 comorbidities. As the total number of comorbidities increased, the likelihood of initiating a DMT decreased. Comorbid anxiety and ischemic heart disease were associated with reduced initiation of a DMT. However, patients with depression were 13% more likely to initiate a DMT compared to those without depression at the index date (adjusted hazard ratio 1.13; 95% confidence interval 1.00-1.27).
conclusionsComorbidities are associated with treatment decisions regarding DMTs in MS. A better understanding of the effects of comorbidity on effectiveness and safety of DMTs is needed.
Indexed as
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.