The impact of autoimmune comorbidities on multiple sclerosis progression: insights from a longitudinal single-center study

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. The presence of other conditions alongside MS imposes a substantial personal and socioeconomic burden. In particular, the impact of comorbid autoimmune diseases (AID) on MS outcomes remains uncertain. In this retrospective longitudinal study, we examined the prevalence of AID in a cohort of patients with different types of MS. For patients with relapsing-remitting MS (RRMS), negative binomial and linear regression models were used to assess adjusted associations between the presence of AID and various other clinical parameters of MS disease. A total of 861 MS patients were included, of whom 148 (17.2%) had one or more comorbid autoimmune diseases (AID). The majority of the patients with MS and AID were women (79.1%). The most prevalent AID was autoimmune thyroiditis (58.1%), followed by psoriasis (16.2%) and type 1 diabetes mellitus (11.5%). Among the 662 RRMS patients, we observed minimal changes in key metrics such as disease-modifying therapies (DMT), relapse rates, steroids dosages, plasma exchanges, or changes in the expanded disability status scale (EDSS) for those with AID. For example, the incident rate of relapses in DMT-naïve patients with AID was nearly identical to that of those without AID (incident rate ratio = 0.92, 95% confidence interval: 0.81 - 1.04). Our findings highlight the notable co-occurrence of AID among patients with MS and suggest that these comorbidities do not affect the progression of RRMS, regardless of DMT use. Reassessing this in large, multicenter, prospective, long-term studies is essential.