Polypharmacy in patients with multiple sclerosis: a gender-specific analysis

Abstract

Background Multiple sclerosis (MS) affects about three times more women than men. Due to variable MS courses, multiple therapies are necessary in clinical practice. Objective We aimed at conducting sex-specific analyses of MS patients regarding polypharmacy (≥ 5 drugs) and at identifying differences in the medication spectrum. Methods Clinico-demographic data were gathered from 306 patients using clinical examinations, structured patient interviews, and patient records. Statistical data analyses were performed to evaluate whether the same or different factors are associated with polypharmacy in both genders. Results Women ( N = 218) and men ( N = 88) showed similar polypharmacy rates (56.0% vs. 58.0%; p = 0.799). For both genders, higher age, severe disability degrees, comorbidities, and inpatient treatment were significantly associated with a higher polypharmacy risk. Low educational levels were predictors of polypharmacy only in women. Fampridine ( p < 0.021) and antispasmodics ( p < 0.010) were used more often by men, while women took more frequently thyroid medications ( p < 0.001) and contraceptives ( p < 0.001). The age-related increase in medication use was much stronger in women ( p < 0.001). Conclusion Male and female MS patients with older age, comorbidities, higher disability degree, and inpatient treatment are at greater risk of polypharmacy. Future studies should examine the occurrence of clinically relevant drug interactions in MS patients stratified by sex.

Association of clinical epidemiological factors to polypharmacy among patients with multiple sclerosis: real-life data

“…Although the degree of disability was moderate, we observed a high number of patients with an EDSS value greater than 5.0, which can be explained by the fact that many patients had been diagnosed several years before. Most Brazilian cohorts reported EDSS values below 4.0 3,19 , similar to values reported in other international studies 6,17,20 .…”

Exploring polypharmacy phenomenon in newly diagnosed relapsing–remitting multiple sclerosis: a cohort ambispective single-centre study

“…25 According to WHO guidelines, polypharmacy in chronic diseases should be monitored carefully because it is linked in the general population to an increase of the drug burden, increases the risk of AEs from drug-drug interactions, reduces functional capacity and raises healthcare costs. 20,25 Figure 5. Kaplan-Meier survival analysis for the event time to first DMT discontinuation.…”

“…25 According to WHO guidelines, polypharmacy in chronic diseases should be monitored carefully because it is linked in the general population to an increase of the drug burden, increases the risk of AEs from drug-drug interactions, reduces functional capacity and raises healthcare costs. 20,25 The debate about structured evaluation of the use of medications is attracting increasing interest. A review of a patient's medication should include engagement with the patient themselves.…”

“…Polypharmacy should be taken into account in MS therapeutic management because it should be included into the MS therapeutic algorithm. 17 – 20 …”

“…Polypharmacy should be taken into account in MS therapeutic management because it should be included into the MS therapeutic algorithm. [17][18][19][20] Studies on DMTs usually consider as outcomes relapse rates, new magnetic resonance imaging (MRI) and/or on safety concerns. However, no studies have assessed the impact of polypharmacy on discontinuing DMT nor on the reasons of discontinuation.…”