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

Marloes T. Bazelier, Tjeerd P. van Staa, Bernard M. J. Uitdehaag, C. Cooper, Hubertus G. M. Leufkens, P. Vestergaard, Ron M. C. Herings, F. de Vries*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


To examine the risk of fracture in patients with multiple sclerosis (MS) compared with population-based controls.A population-based cohort study was performed in the Dutch PHARMO Record Linkage System (1998-2008). Patients with MS (n = 2,415) were matched by year of birth, sex, and practice to up to 6 patients without MS (controls). We used Cox proportional hazards models to estimate the hazard ratio (HR) of fracture in MS. Time-dependent adjustments were made for age, history of disease, and drug use.During follow-up, there were 59 fractures among patients with MS (2.4%) and 227 fractures among controls (1.8%). Patients with MS had a 1.7-fold increased risk of osteoporotic fracture (HR 1.73 [95% confidence interval (CI) 1.18-2.53]) and a 4-fold increased risk of hip fracture (HR 4.08 [95% CI 2.21-7.56]). The risk of osteoporotic fracture was significantly greater for patients with MS who had been prescribed antidepressants (HR 3.25 [95% CI 1.77-5.97]) or hypnotics/anxiolytics (HR 3.40 [95% CI 2.06-5.63]) in the previous 6 months, compared with controls.Increased awareness of the risk of hip fracture is warranted in patients with MS, especially in those who have recently been prescribed antidepressants or hypnotics/anxiolytics.
Original languageEnglish
Pages (from-to)1967-1973
Issue number24
Publication statusPublished - Jun 2012


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