Multiple Sclerosis is known as a progressive disease in which symptoms worsen over time. But for some 85% of those who suffer, the first stages of the illness come in waves. The individual may feel perfectly well some days while others are marked with worsening or new symptoms.
Officially this condition is known as relapsing remitting multiple sclerosis (MS) and it is the focus of a large Canadian conglomerate known as the CIHR Team in Epidemiology and Impact of Comorbidity on Multiple Sclerosis, or ECoMS. As the name implies, the group aims to determine how co-existing chronic diseases – comorbidities – affect those suffering with MS. Last week, representatives of the team, headed by Dr. Ruth Ann Marrie at the University of Manitoba and Director of Manitoba’s MS Clinic at Health Sciences Centre Winnipeg, revealed their findings in the journal, Neurology.
There has been a need for this information, as Marrie explains. “We’ve learned how chronic conditions may influence some aspects of MS such as pain and fatigue,” Marrie says. “But we did not know how comorbid conditions might affect relapses which are particularly important early in the disease. We undertook this effort to identify one or more possible links.”
The team recruited 885 people who visited MS clinics in four provinces annually for two years. The team reviewed medical records to determine who had experienced a relapse since their last visit. At each visit, the participants completed questionnaires asking whether they suffered from one or more of a long list of chronic ailments such as high cholesterol, diabetes, gastrointestinal ailments, high blood pressure, migraine, and rheumatoid arthritis. “We wanted to make sure we considered all of the conditions that were common in MS or were reported to affect other aspects of MS,” Marrie says.
When the results came back, as Marrie explains, they were mixed. A person suffering from at least three different conditions had an increased risk of relapse. “We found no link between diabetes, heart disease, or depression. But there were some surprises in store. “We saw associations between relapse and both migraines and high levels of cholesterol. This has not been observed in previous studies.”
The outcome of this study can offer some perspective on the impact of chronic disease in MS. For doctors who treat patients suffering from relapsing remitting MS, these results suggest areas to address to prevent future relapse. “Both migraines and high cholesterol levels can be treated,” Marrie says. We can study whether treating people with MS and migraines or high cholesterol should be treated differently.”
Marrie also believes this discovery offers hope and highlights the importance of wellness approaches in MS. “A healthy diet, quitting smoking and regular physical activity reduce the risk of developing some chronic conditions, and may reduce the chances for relapse in addition to MS-specific treatments.”
If you wish to learn more about Multiple Sclerosis, you can find more information at the MS Society of Canada at https://mssociety.ca/ .
The article, “Comorbidity increases the risk of relapse in multiple sclerosis” can be found here: http://www.neurology.org/content/early/2017/11/08/WNL.0000000000004716.abstract
