Abstract General Information

Title

History of immunosuppressant therapies and comorbidity prevalence in patients with multiple sclerosis older than 55 years

Abstract

Introduction:
Older patients with multiple sclerosis (MS) were not included in pivotal clinical trials and are more likely to have been exposed to immunosuppressant (IMS), due to unavailability of approved drugs at their time of diagnosis. This population may suffers from more comorbidities than younger patients, which can lead to accumulated disabilities and health complications.

Objective:
To describe the occurrence of comorbidities in patients older than 55 years and compare groups about exposure to IMS therapies.

Methods:
We performed a retrospective observational study with real life data based on medical records. 95 patients were included and we compared the likelihood of main comorbidities in IMS exposed and unexposed patients in a single center.

Results:
The mean and SD for age was 62.1 (5.1) years, and majority were women (n=75, 78.9%). The mean EDSS was 4.5 (2.5) points. Eighteen (19%) patients have been into IMS therapies – azathioprine (7), mitoxantrone (7), methotrexate (5), cyclophosphamide (4) and stem cells transplantation (2). Five had been into more than one IMS. Also considering common DMT, the mean exposure was to 3 drugs during disease course. The most prevalent comorbidities in the sample were psychiatric disorders (n=50, 52.6%), followed by hypertension (n=39, 41.1%), dyslipidemia (n=25, 26.3%) and thyroid dysfunction (n=20, 21.1%). In the IMS group, twelve (66.7%) had psychiatric disorders (HR 2.05 [95% CI 0.69-6.02]; p=0.19), eight (44.4%) had hypertension (HR 1.18 [95% CI 0.42-3.34]; p=0.74), five (27.7%) had dyslipidemia (HR 1.09 [95% CI 0.34-3.46]; p=0.87), and three (16.7%) had thyroid dysfunction (HR 0.70 [95% CI 0.18-2.72]; p=0.61). One exposed had cancer, against four unexposed. No patient presented opportunistic infections or serious autoimmune disorders.

Conclusion:
In our small sample, patients exposed to IMS therapies did not presented a different profile of comorbidities.