The use of valproic acid and multiple sclerosis

Abstract

In the first human study addressing a possible beneficial effect of VPA use on the risk of MS, we found no support for a protective effect. However, given the wide confidence intervals, only large effects can be ruled out with sufficient certainty.

Drug exposure and the risk of multiple sclerosis: A systematic review

“…The anticonvulsant, valproic acid (VPA) was assessed in 1 population‐based Danish cohort study (1997–2011) . Utilizing the Danish Civil Registration System and the Prescription Drug Registry, a cohort of 16 028 ever‐users of VPA were identified.…”

“…There was no association between VPA use and risk of MS. After adjusting for age, use of other anti‐epileptic drugs, and history of epilepsy, VPA current‐users had no altered risk of MS (adj.hazard ratio [HR] = 1.30;95% CI:0.44–3.80), nor did VPA former‐users (adj.HR =1.22;95%CI:0.28–5.32). In an intention‐to‐treat analysis, ever‐users of VPA had a 2‐fold increased risk of MS (HR = 2.41;95%CI:1.32–4.43), but the authors ultimately concluded that there was no association between VPA use and risk of MS …”

“…A total of 7 unique drug classes were examined. A number of drugs were not associated with MS risk, in either single studies or in the majority of published work, including amiloride (relative to thiazide), valproic acid, and the OCs . Intriguingly, a reduced risk of MS was observed with exposure to fenoterol (a beta2‐adrenergic agonist) and the sedating histamine 1‐receptor antagonists .…”

“…Despite the systematic approach, it remains possible that studies were missed; publication bias might influence the decision to publish by authors or Editors. Four drugs were investigated in single studies only ; replication and validation of these findings would be valuable. Three of the 7 drug classes were examined in more than 1 study, with differences in findings observed .…”

“…The anticonvulsant, valproic acid (VPA) was assessed in 1 populationbased Danish cohort study (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). 20 6 valproic acid, 20 and the OCs. [15][16][17][18][19] Intriguingly, a reduced risk of MS was observed with exposure to fenoterol (a beta2-adrenergic agonist) 12 and the sedating histamine 1-receptor antagonists.…”