Murphy, O;
Zandi, MS;
Lindenberg, N;
Murphy, E;
Chataway, J;
(2016)
Bone health in patients with multiple sclerosis relapses.
Multiple Sclerosis and Related Disorders
, 6
pp. 75-80.
10.1016/j.msard.2016.02.003.
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Abstract
OBJECTIVES: To evaluate the bone health and vitamin D levels of a cohort of patients with relapses of multiple sclerosis (MS) and to propose an algorithm for the management of bone health in this patient group. METHODS: We prospectively studied 56 consecutive patients from our acute relapse clinic. 3 patients were excluded from analysis as they were not deemed to have experienced an acute MS relapse. Bone health was assessed with vitamin D levels and Dual Energy X-ray Absorptiometry (DEXA) scanning (10 patients failed to attend for DEXA). Statistical analyses were used to compare groups and identify predictive variables. A review of the literature led to a proposed management protocol. RESULTS: Pre-relapse the baseline EDSS was ≤6.5 in all subjects, and <4.0 in the majority (66%). Most received corticosteroids. 51% had low bone mineral density (BMD) as defined by a T-score less than −1.0 on DEXA scanning. Three were osteoporotic (T-score less than −2.5). Thirty one of fifty (62%) subjects were Vitamin D deficient (25(OH)D less than 50 nmol/L). A range of variables, including previous corticosteroid usage, were not significantly predictive of reduced BMD. CONCLUSIONS: There was a high frequency of both low BMD and Vitamin D deficiency in this cohort of relatively young and largely ambulatory patients experiencing MS relapses. Current tools, such as the WHO FRAX algorithm, are inadequate in assessing bone status and fracture risk in this patient group, predominantly as they are focused on older age groups. We propose a simple clinical management algorithm.
| Type: | Article |
|---|---|
| Title: | Bone health in patients with multiple sclerosis relapses |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.msard.2016.02.003 |
| Publisher version: | http://dx.doi.org/10.1016/j.msard.2016.02.003 |
| Language: | English |
| Additional information: | Copyright © 2016. This manuscript version is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International licence (CC BY-NC-ND 4.0). This licence allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licences are available at http://creativecommons.org/licenses/by/4.0. Access may be initially restricted by the publisher. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences & Neurology, Multiple sclerosis, Metabolic bone disease, Bone mineral density, Vitamin D, Vitamin-d Status, Mineral Density, 25-hydroxyvitamin D, Risk, Osteoporosis, Fracture, Methylprednisolone, Therapy, Dietary, Pulses |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1489370 |
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