The Potential Correlation Between MS Medication and Decreased Bone Density

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With a typical onset between the ages of 20 and 40, multiple sclerosis (MS) currently affects 2.8 million people worldwide and is the most common nontraumatic neurological disability in young adults. People with MS are often prescribed medications that could potentially affect bone health and lead to osteoporosis, a common problem among people with MS.

A recent study from the School of Clinical Sciences at Montash University in Australia, published in the Journal of Managed Care and Specialty Pharmacy by Michael Cahyadi ,aims to figure out the potential these medications have on areal bone mineral density (aBMD).

To find answers, researchers combed through data published in MEDLINE, Embase, Scopus, CINAHL and Web of Science and settled on 22 studies. They focused specifically on the effects of glucocorticoid, antidepressant, anticonvulsant, anxiolytic, opioid, and antipsychotic medication and found conflicting data, partly due to an insufficient number of studies.

Although research identified a significant inverse relationship between glucocorticoids and decreased femoral neck bone density, the authors report that the data is not comprehensive enough to confirm a direct correlation.

Antidepressant and anxiolytic use were not associated with loss of bone density but only five studies were found.

There was not enough data to conclude the effects of anticonvulsants, opioids and antipsychotics.

Although research is inconclusive the authors recommend that patients on these medications continue to be monitored for bone frailty as more evidence comes out.

“Future studies require attention to how medication use is measured, including reduced reliance on retrospective self-report data, which is known to suffer memory bias, and increased attention to measuring medication class, dose, mode, and duration of administration,” the authors write. “Additional high-quality studies with homogenous methodology exploring how medications influence aBMD and fracture risk in people with MS are required.”