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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 publication

DOI

10.1212/wnl.0b013e318259e0ff

Type

Conference paper

Publication Date

06/2012

Volume

78

Pages

1967 - 1973

Addresses

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

Keywords

Humans, Multiple Sclerosis, Hip Fractures, Risk, Risk Factors, Cohort Studies, Databases, Factual, Adolescent, Adult, Aged, Middle Aged, Netherlands, Female, Male, Fractures, Bone, Osteoporotic Fractures