Vascular comorbidity associated with worse disability in MS

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Vascular comorbidity associated with worse disability in MS

Postby eric593 » Wed Mar 31, 2010 3:40 am

Neurology. 2010 Mar 30;74(13):1041-7.

Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis.
Marrie RA, Rudick R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T.

Health Sciences Center, GF-533, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada rmarrie@hsc.mb.ca.

BACKGROUND: Vascular comorbidity adversely influences health outcomes in several chronic conditions. Vascular comorbidities are common in multiple sclerosis (MS), but their impact on disease severity is unknown. Vascular comorbidities may contribute to the poorly understood heterogeneity in MS disease severity. Treatment of vascular comorbidities may represent an avenue for treating MS. METHODS: A total of 8,983 patients with MS enrolled in the North American Research Committee on Multiple Sclerosis Registry participated in this cohort study. Time from symptom onset or diagnosis until ambulatory disability was compared for patients with or without vascular comorbidities to determine their impact on MS severity. Multivariable proportional hazards models were adjusted for sex, race, age at symptom onset, year of symptom onset, socioeconomic status, and region of residence. RESULTS: Participants reporting one or more vascular comorbidities at diagnosis had an increased risk of ambulatory disability, and risk increased with the number of vascular conditions reported (hazard ratio [HR]/condition for early gait disability 1.51; 95% confidence interval [CI] 1.41-1.61). Vascular comorbidity at any time during the disease course also increased the risk of ambulatory disability (adjusted HR for unilateral walking assistance 1.54; 95% CI 1.44-1.65). The median time between diagnosis and need for ambulatory assistance was 18.8 years in patients without and 12.8 years in patients with vascular comorbidities. CONCLUSIONS: Vascular comorbidity, whether present at symptom onset, diagnosis, or later in the disease course, is associated with a substantially increased risk of disability progression in multiple sclerosis. The impact of treating vascular comorbidities on disease progression deserves investigation.

PMID: 20350978 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20350978
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Postby bretzke » Wed Mar 31, 2010 6:13 am

CONCLUSIONS: Vascular comorbidity, whether present at symptom onset, diagnosis, or later in the disease course, is associated with a substantially increased risk of disability progression in multiple sclerosis. The impact of treating vascular comorbidities on disease progression deserves investigation.


Great find Eric. This could be huge!
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Postby Billmeik » Wed Mar 31, 2010 7:01 am

wow over 8000 patients were looked at!

The fact that they only see the 'comorbity' on some severe patients could be that there's nothing to see but it could also be that they don't know how to look.

The fact that such a mainstream paper says that fixing 'vascular comorbity' is an important treatment avenue is huge!

Still dont like these new tems. A bit morbid.
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Postby frodo » Sun May 09, 2010 1:01 pm

I had missed this article!!! This justifies that patients request treatment for CCSVI regardless whether CCSVI is its cause!!!
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Hard to explain away

Postby fiddler » Sun May 09, 2010 2:45 pm

Almost 9000 subjects? That is not so easy to explain away as a "small study"and, since I can't think of why MS progression would cause increased vascular problems, also seems to justify CCSVI treatment now, not after "proof" that MS is caused or exacerbated by venous problems.

By the way, for those skeptics who say that it is almost only Zamboni and his colleagues who have published about CCSVI, you can only say that if you willfully ignore many other research results over many years that point to blood flow problems, iron deposition and non-auto-immune initiation of de-myelinization.

Skepticism is good, willful blindness not so.

...Ted
Dx SPMS in 2004.  Liberated 29/04/2010.
My blog: www.my-darn-ms.blogspot.com
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Postby Billmeik » Sun May 09, 2010 2:55 pm

this same paper was in ang int a month or 2 ago. It looks far more impressive with 'neurology' at the top but I thought it was cool then
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Postby Billmeik » Sun May 09, 2010 2:57 pm

oops it just came out around the same time as the ang int stuff.
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