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Risk of fractures in patients with multiple sclerosis: a population-based cohort study

M T Bazelier1, T-P van Staa, B M J Uitdehaag

  • 1Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.

Neurology
|May 18, 2012
PubMed
Abstract

Insights

Patients with multiple sclerosis (MS) face a higher fracture risk, particularly hip fractures. This risk is amplified by recent prescriptions for antidepressants or hypnotics/anxiolytics.

Area of Science:

  • Neurology
  • Epidemiology
  • Gerontology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease.
  • Fracture risk in MS patients is not well-established.
  • Comorbidities and medication use may influence fracture risk.

Purpose of the Study:

  • To investigate the risk of fracture in patients diagnosed with multiple sclerosis (MS).
  • To compare fracture incidence in MS patients against population-based controls.
  • To identify specific risk factors associated with fractures in MS.

Main Methods:

  • A population-based cohort study utilizing the Dutch PHARMO Record Linkage System (1998-2008).
  • Matching 2,415 MS patients with up to 6 controls based on birth year, sex, and practice.
  • Employing Cox proportional hazards models with time-dependent adjustments for age, disease history, and drug use.

Main Results:

  • MS patients exhibited a 1.73-fold increased risk of osteoporotic fractures and a 4.08-fold increased risk of hip fractures.
  • Fracture incidence was 2.4% in MS patients versus 1.8% in controls.
  • Prescription of antidepressants or hypnotics/anxiolytics within 6 months significantly elevated osteoporotic fracture risk in MS patients.

Conclusions:

  • Patients with multiple sclerosis (MS) have an elevated risk of osteoporotic and hip fractures.
  • Prescribing antidepressants or hypnotics/anxiolytics to MS patients warrants careful consideration due to increased fracture risk.
  • Enhanced vigilance for fracture risk is crucial in MS management, especially for those on specific medications.

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