Polish archives of internal medicine · 2026
Multiple sclerosis in patients with rheumatoid arthritis: a nationwide, pilot study from Poland based on health care claims (2009-2021).
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Żur-Wyrozumska Kamila, Szeląg Mateusz, Borowy Przemysław, Krajewska-Włodarczyk Magdalena, Żuber Zbigniew, Podwójcic Krzysztof, Maluchnik Michał, Batko Krzysztof, Kwiatkowska Brygida, Stajszczyk Marcin, Krawiec Piotr, Batko Bogdan
Аннотация
INTRODUCTION: Multiple sclerosis (MS) and rheumatoid arthritis (RA) are common, chronic immune‑mediated diseases that share pathogenetic pathways, but their epidemiologic relationship is uncertain.
OBJECTIVES: We aimed to describe the association between MS and RA in the Polish population.
PATIENTS AND METHODS: This pilot, nationwide study was based on administrative health care claims sourced from the Polish National Health Fund (NHF). Between 2009 and 2021, MS and RA cases were identified through a combination of the International Classification of Diseases, Tenth Revision claims, in conjunction with the Anatomical Therapeutic Chemical codes for medications or drug program records. Annual prevalence and incidence trends were assessed. Within the study timeframe, a retrospective cohort of RA patients and a general population-based comparator were recruited, with year‑ by year assessment of MS burden. The controls were matched 1:1 for age, sex, and calendar year of RA diagnoses, from individuals with any NHF contact in the corresponding year.
RESULTS: In the years 2009-2021, 464 cases of concurrent MS were identified among patients with RA, whereas 813 MS cases were found in the matched control group (n = 307 519 per group). While the overall population trends suggest increased MS prevalence, annual incidence declined (P <0.001 for both RA and control), in combination with increasing age at MS diagnosis. Age- and serotype‑ specific analyses suggested that young (16-39 y) women with RA had higher MS prevalence (37.2 vs 26.9 per 10 000 patients; prevalence ratio, 1.39; 95% CI, 1-1.92; P = 0.048) than the controls. Conversely, older women with RA showed significantly lower MS prevalence rates. Mortality was comparable in both groups.
CONCLUSIONS: Overall, RA was not associated with an increased overall MS risk, as compared with the general population. Young women with seronegative RA may be at a greater risk of MS, which warrants clarification of age, sex, and serotype‑ specific risk disparities in future prospective longitudinal studies. However, clinical vigilance for atypical MS symptoms in young women with RA should be maintained.
OBJECTIVES: We aimed to describe the association between MS and RA in the Polish population.
PATIENTS AND METHODS: This pilot, nationwide study was based on administrative health care claims sourced from the Polish National Health Fund (NHF). Between 2009 and 2021, MS and RA cases were identified through a combination of the International Classification of Diseases, Tenth Revision claims, in conjunction with the Anatomical Therapeutic Chemical codes for medications or drug program records. Annual prevalence and incidence trends were assessed. Within the study timeframe, a retrospective cohort of RA patients and a general population-based comparator were recruited, with year‑ by year assessment of MS burden. The controls were matched 1:1 for age, sex, and calendar year of RA diagnoses, from individuals with any NHF contact in the corresponding year.
RESULTS: In the years 2009-2021, 464 cases of concurrent MS were identified among patients with RA, whereas 813 MS cases were found in the matched control group (n = 307 519 per group). While the overall population trends suggest increased MS prevalence, annual incidence declined (P <0.001 for both RA and control), in combination with increasing age at MS diagnosis. Age- and serotype‑ specific analyses suggested that young (16-39 y) women with RA had higher MS prevalence (37.2 vs 26.9 per 10 000 patients; prevalence ratio, 1.39; 95% CI, 1-1.92; P = 0.048) than the controls. Conversely, older women with RA showed significantly lower MS prevalence rates. Mortality was comparable in both groups.
CONCLUSIONS: Overall, RA was not associated with an increased overall MS risk, as compared with the general population. Young women with seronegative RA may be at a greater risk of MS, which warrants clarification of age, sex, and serotype‑ specific risk disparities in future prospective longitudinal studies. However, clinical vigilance for atypical MS symptoms in young women with RA should be maintained.