Most efforts aimed at understanding the notable heterogeneity of outcomes in multiple sclerosis (MS) have focused on disease-specific factors, such as symptoms at initial presentation, initial relapse rate, and age at symptom onset. These factors, however, explain relatively little of the heterogeneity of disease outcomes. Owing to the high prevalence of comorbidity in MS and the potential for its prevention or treatment, comorbidity is of rising interest as a factor that could explain the heterogeneity of outcomes. A rapidly growing body of evidence suggests that comorbidity adversely affects outcomes throughout the disease course in MS, including diagnostic delays from symptom onset, disability at diagnosis and subsequent progression, cognition, mortality, and health-related quality of life. Therefore, clinicians need to incorporate the prevention and management of comorbidity when treating patients with MS, but managing comorbidities in MS successfully may require the adoption of new collaborative models of care.

译文

大多数旨在了解多发性硬化症 (MS) 结局的显着异质性的努力都集中在疾病特异性因素上,例如初始表现时的症状,初始复发率和症状发作时的年龄。然而,这些因素对疾病结局异质性的解释相对较少。由于MS中合并症的高患病率及其预防或治疗的潜力,合并症作为可以解释结果异质性的一个因素引起了人们的关注。快速增长的证据表明,合并症会对MS的整个病程产生不利影响,包括症状发作的诊断延迟,诊断时的残疾以及随后的进展,认知,死亡率和与健康相关的生活质量。因此,临床医生在治疗MS患者时需要结合合并症的预防和管理,但是成功地管理MS中的合并症可能需要采用新的协作护理模式。

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