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Interrogation of the Multiple Sclerosis Prodrome Using High-Dimensional Health Data
Yinshan Zhao1, José M A Wijnands2, Tanja Högg3
1Department of Medicine (Neurology), University of British Columbia and The Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada, yinshan@mail.ubc.ca.
Neuroepidemiology
|January 16, 2020
Summary
The multiple sclerosis (MS) prodrome may be identified by specific medication use. MS cases showed higher prescription rates for medications like antivertigo preparations and anti-epileptics years before diagnosis.
Area of Science:
- Neurology
- Epidemiology
- Pharmacology
Background:
- Growing evidence suggests a prodromal period preceding multiple sclerosis (MS) onset.
- Understanding this prodrome is crucial for early MS detection, treatment, and identifying risk factors.
Purpose of the Study:
- To investigate associations between diagnostic codes and medication classes in the 5 years before MS diagnosis.
- To delineate the prodromal phase of MS using statistical learning techniques.
Main Methods:
- A matched cohort study utilized Canadian health administrative data (1996-2013).
- LASSO and multivariate logistic regressions analyzed 7 specific medication classes and associated diagnostic codes in 4,862 MS cases and 22,649 controls.
Main Results:
- MS cases exhibited significantly higher prescription rates for antivertigo preparations, anti-epileptics, glucocorticoids, urinary anti-spasmodics, and muscle relaxants.
- These medication usage patterns were not fully explained by diagnostic codes alone, suggesting a potential prodromal signature.
Conclusions:
- Elevated use of certain medications in the 5 years preceding a demyelinating claim may indicate the MS prodrome.
- This medication overrepresentation could serve as a key indicator for the MS prodromal period.
