Bone health in patients with multiple sclerosis relapses

Area of Science:

• Neurology
• Endocrinology
• Bone Metabolism

Background:

• Multiple sclerosis (MS) is a chronic neurological disease impacting bone health.
• Relapsing forms of MS often involve corticosteroid treatment, a known risk factor for bone loss.
• Bone health and vitamin D status in MS relapse cohorts require thorough evaluation.

Purpose of the Study:

• To assess bone health and vitamin D levels in patients with relapsing multiple sclerosis.
• To identify factors influencing bone health in this population.
• To develop a management algorithm for bone health in relapsing MS.

Main Methods:

• Prospective study of 56 consecutive patients with acute MS relapses.
• Bone health assessment via Dual Energy X-ray Absorptiometry (DEXA) and serum vitamin D levels (25(OH)D).
• Statistical analysis to compare groups and identify predictive variables; literature review for protocol development.

Main Results:

• 51% of patients exhibited low bone mineral density (BMD) (T-score < -1.0); 3 were osteoporotic (T-score < -2.5).
• 62% of subjects were vitamin D deficient (25(OH)D < 50 nmol/L).
• Predictive variables, including prior corticosteroid use, did not significantly correlate with reduced BMD.

Conclusions:

• High prevalence of low BMD and vitamin D deficiency observed in relapsing MS patients.
• Existing tools like the WHO FRAX algorithm are insufficient for assessing bone status in this demographic.
• A simplified clinical management algorithm for bone health in relapsing MS is proposed.