{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T22:11:19Z","timestamp":1781820679984,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The study aims to examine the age and disability levels at diagnosis in people with multiple sclerosis (PwMS), with and without autoimmune comorbidities (AC), and the effect of AC on NEDA\u20103 status and to characterize AC associated with MS, comparing also therapeutic approaches between MS patients with and without other AC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based, multicentric study enrolled patients with relapsing\u2013remitting MS (RRMS) with AC (AC group) or without AC (reference group) from 14 MS centers. Demographical, clinical features, treatment information, MRI activity, EDSS, and no evidence of disease activity (NEDA\u20103) status were assessed at T36 (enrollment time) and T0 (36\u2009months prior).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight hundred seventy\u2010three RRMS patients were included; 215 (24.7%) presented with at least one AC. The AC group was characterized by higher proportion of female patients than reference group (<jats:italic>p<\/jats:italic>\u2009=\u20090.008). Patients with AC, compared to reference group, exhibited older age at MS onset and MS diagnosis, and higher EDSS score at diagnosis, at T0 (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and T36 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). The proportion of patients reaching EDSS 4 was higher in reference group than AC group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). People in AC group were more often treated with glatiramer acetate, natalizumab, and rituximab, whereas PwMS from reference group with interferon\u2010beta and fingolimod at T0 and T36. The risk of losing NEDA\u20103 was lower in AC group (OR\u2009=\u20090.61, 95% CI 0.43\u20130.86, <jats:italic>p<\/jats:italic>\u2009=\u20090.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AC are common in PwMS and can be related to a delay in onset, diagnosis and higher disability at MS presentation. However, the coexistence of AC is not associated with a worse prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70019","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:52:12Z","timestamp":1735199532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of autoimmune comorbidities on multiple sclerosis course: An observational multicenter study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-3948","authenticated-orcid":false,"given":"Viviana","family":"Nociti","sequence":"first","affiliation":[{"name":"Multiple Sclerosis Research Center \u2018Anna Paola Batocchi\u2019, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-3141","authenticated-orcid":false,"given":"Marina","family":"Romozzi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Research Center \u2018Anna Paola Batocchi\u2019, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3237-6267","authenticated-orcid":false,"given":"Luca","family":"Prosperini","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center Neurology Unit S. Camillo\u2010Forlanini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina Torri","family":"Clerici","sequence":"additional","affiliation":[{"name":"Neuroimmunology and Neuromuscular Diseases Unit Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2516-1567","authenticated-orcid":false,"given":"Paolo","family":"Ragonese","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neurosciences and advanced Diagnostics University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2203-6237","authenticated-orcid":false,"given":"Antonio","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences (DAMSS) University of Campania \u201cLuigi Vanvitelli\u201d  Caserta Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia Teresa","family":"Maniscalco","sequence":"additional","affiliation":[{"name":"Neurological Clinic\u2010Stroke Unit and Multiple Sclerosis Center \"A. Cardarelli\" Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-7477","authenticated-orcid":false,"given":"Massimiliano","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Buscarinu","sequence":"additional","affiliation":[{"name":"Centre for Experimental Neurological Therapies (CENTERS), Department of Neurosciences, Mental Health and Sensory Organs Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-2908","authenticated-orcid":false,"given":"Lorena","family":"Lorefice","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center Binaghi Hospital  Cagliari Italy"},{"name":"Department of Medical Sciences and Public Health University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pinardi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle scienze neurologiche di Bologna UOSI Riabilitazione Sclerosi Multipla  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Gajofatto","sequence":"additional","affiliation":[{"name":"Dipartimento di Neuroscienze, Biomedicina e Movimento Universit\u00e0 di Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Cavalla","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center, University Neurology Unit 1, Department of Neurosciences and Mental Health AOU City of Health &amp; Science University Hospital  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Buttari","sequence":"additional","affiliation":[{"name":"Unit of Neurology &amp; Neurorehabilitation IRCCS Neuromed  Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-3806","authenticated-orcid":false,"given":"Diana","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Neurology Unit, Ospedale Civile di Baggiovara Azienda Ospedaliero\u2010Universitaria di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"De Luca","sequence":"additional","affiliation":[{"name":"MS Centre, Neurology Unit SS. Annunziata University Hospital  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6167-3987","authenticated-orcid":false,"given":"Claudio","family":"Solaro","sequence":"additional","affiliation":[{"name":"Rehabilitation Department Mons. L. Novarese  Vercelli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3959-4067","authenticated-orcid":false,"given":"Claudio","family":"Gasperini","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center Neurology Unit S. Camillo\u2010Forlanini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Cocco","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center Binaghi Hospital  Cagliari Italy"},{"name":"Department of Medical Sciences and Public Health University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"RIREMS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13819"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011242"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517703193"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-52001-2.00003-0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12111828"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00851"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10107-y"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13111524"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10194-x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000333252.78173.5f"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2017.33"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514564490"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1414"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70132-1"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00393-2"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-015-0412-4"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13669"},{"issue":"21","key":"e_1_2_9_20_1","first-page":"1","article-title":"Pathophysiology of autoimmune diseases","volume":"68","author":"Boitard C","year":"1990","journal-title":"Klin Wochenschr"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002564"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000269"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1054773815592817"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2009.09.014"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2016.09.003"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513515081"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.11.007"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa453"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4681"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8811-1"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000442203"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1089\/jir.2011.0065"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2022.1013933"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T05:15:58Z","timestamp":1737954958000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,25]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/ene.70019"],"URL":"https:\/\/doi.org\/10.1111\/ene.70019","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,25]]},"assertion":[{"value":"2024-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70019"}}