TY - JOUR
T1 - Risk of fractures in patients with multiple sclerosis A population-based cohort study
AU - Bazelier, Marloes T.
AU - van Staa, Tjeerd P.
AU - Uitdehaag, Bernard M. J.
AU - Cooper, C.
AU - Leufkens, Hubertus G. M.
AU - Vestergaard, P.
AU - Herings, Ron M. C.
AU - de Vries, F.
PY - 2012/6
Y1 - 2012/6
N2 - 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.
AB - 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.
U2 - 10.1212/WNL.0b013e318259e0ff
DO - 10.1212/WNL.0b013e318259e0ff
M3 - Article
C2 - 22592374
SN - 0028-3878
VL - 78
SP - 1967
EP - 1973
JO - Neurology
JF - Neurology
IS - 24
ER -