期刊
NEUROLOGY
卷 78, 期 24, 页码 1967-1973出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e318259e0ff
关键词
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资金
- GlaxoSmithKline
- Novo Nordisk
- Top Institute Pharma
- Dutch Medicines Evaluation Board
- Dutch Ministry of Health
- MHRA
- Medical Research Council
- European Calcified Tissue Society
- Medical Research Council [U1475000001, MC_U147585824, MC_UP_A620_1014] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10082] Funding Source: researchfish
Objective: To examine the risk of fracture in patients with multiple sclerosis (MS) compared with population-based controls. Methods: 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. Results: 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. Conclusions: 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. Neurology (R) 2012; 78: 1967-1973
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